Objective To explore the combined predictive value of Diaphragmatic Excursion-Rapid Shallow Breathing Index (DE-RSBI) and Diaphragmatic Thickening Fraction-Rapid Shallow Breathing Index (DTF-RSBI) in relation to weaning outcomes. Methods A total of 68 critically ill pediatric pneumonia patients who were on mechanical ventilation at the Second Affiliated Hospital of Jiaxing University from January 2021 to February 2023 were included. All patients underwent a spontaneous breathing trial (SBT),and based on the weaning outcomes,they were categorized into two groups:the successful weaning group (46 cases) and the weaning failure group (22 cases). A binary logistic regression analysis was conducted to develop a regression equation,and the ROC curve was utilized for analysis. Results The results revealed a statistically significant difference in both DE-RSBI and DTF-RSBI between the successful weaning and the weaning failure groups (P<0.05). By employing DE-RSBI and DTF-RSBI as independent variables and the weaning failure of preschool mechanical ventilation patients as the binary dependent variable,a binary logistic regression equation was formulated. The findings indicated that both DE-RSBI and DTF-RSBI were independent risk factors for weaning failure in preschool mechanical ventilation patients (OR=1.01.989,95％CI:1.407～12.813,P<0.01;OR=1.047,95％CI:1.011～1.084,P=0.011). The receiver operating characteristic (ROC) curve analysis demonstrated that the areas under the curve (AUC) for predicting weaning failure in pediatric mechanical ventilation patients were 0.859 for DE-RSBI (95％CI:0.772～0.947,P<0.01),0.82 for DTF-RSBI (95％CI:0.719～0.921,P<0.01),and 0.893 for the combined index (95％CI:0.818～0.968,P<0.01),respectively. Utilizing the principle of maximizing the Yoden index,the optimal cutoff values for DE-RSBI and DTF-RSBI in predicting weaning failure in preschool mechanical ventilation patients were identified as 17.71 breaths/(min·dm) and 90.0 breaths/(min·％),with sensitivities of 96.2％ and 76.9％,and specificities of 73.8％ and 83.3％,respectively. Conclusion This study suggests that DE-RSBI and DTF-RSBI are independent risk factors for weaning in pediatric patients,and the concurrent monitoring of DE-RSBI and DTF-RSBI offers predictive value for the weaning outcomes of preschool children receiving mechanical ventilation.
万方数据
维普
