Predictive value of ultrasound combined with respiratory mechanics in-dexes in weaning outcomes of patients with severe pneumonia
Objective To evaluate the predictive value of ultrasound combined with respiratory mechanics indexes in weaning outcomes of patients with severe pneumonia.Methods A total of 72 patients with severe pneumonia who were scheduled to be weaning admitted to the intensive care unit of the No1.People's Hospital of Pinghu,Zhejiang Province from May 2022 to May 2023 were selected as the study objects.The endotracheal tube was removed in all patients after 30 min spontaneous breathing test.Before weaning,ultrasound was used to evaluate lung function and diaphragm function,and respiratory mechanics parameters were recorded.Patients were divided into failed group(20 cases)and successful group(52 cases)based on the outcome of weaning.The clinical indexes of the two groups were compared,and the predictive value of lung ultrasound score(LUS),diaphragmatic displacement(DD),diaphragm thickening fraction(DTF),rapid shallow breathing index(RSBI),and airway occlusion pressure at 0.1s(P0.1)were evaluated by receiver operating characteristic curve.Results DD and DTF in the successful group were larger than those in the failed group,and mechanical ventilation time,respiratory rate,LUS,RSBI,and P0.1 were smaller than those in the failed group(P＜0.05).Logistic multivariate analysis showed that mechanical ventilation time,respiratory rate,LUS,DD,DTF,RSBI,and P0.1 were influencing factors of weaning outcomes(P＜0.05).The area under the curve of LUS,DD,DTF,RSBI,and P0.1 for predicting weaning successful were 0.85,0.70,0.84,0.78,and 0.75,the sensitivity of 75.0％,63.5％,86.5％,65.0％,and 80.0％,the specificity of 84.6％,65.0％,75.0％,84.6％,and 61.5％.Assign score of 0 or 1 to each index based on optimal critical value and calculate comprehensive score.The area under the curve for predicting weaning successful by comprehensive score was 0.94,the cut-off value was 2.5 with a sensitivity of 85.0％and a specificity of 88.5％.Conclusion For patients with severe pneumonia,comprehensive evaluation of lung function and diaphragm function through ultrasound,combined with respiratory mechanics parame-ters during weaning,may be more conducive to clinical weaning decisions.
Severe pneumoniaLung ultrasoundDiaphragm ultrasoundRespiratory mechanicsWeaning
NETL
NSTL
万方数据
