Ultrasonographic diaphragm parameters in predicting outcomes of postoperative mechanical ventilation weaning in patients with type A aortic dissection
Objective To explore the predictive value of diaphragmatic ultrasound parameters in assessing the outcome of weaning from mechanical ventilation in patients with type A aortic dissection.Methods Clinical data of 101 patients who underwent mechanical ventilation for≥48 h after type A aortic dissection surgery in Cardiac Intensive Care Unit(CICU)of the First Affiliated Hospital of Wenzhou Medical University from November 2022 to December 2023 were retrospectively analyzed.Before weaning,all patients underwent diaphragmatic ultrasonography to assess diaphragm excursion(DE)and diaphragm thickening fraction(DTF).Among them,77 patients did not require reinstitution of noninvasive or invasive mechanical ventilation within 48 h after weaning(successful weaning group);and 24 patients either failed the spontaneous breathing trial(SBT)and died after weaning,or required reinstitution of noninvasive or invasive mechanical ventilation within 48 h after weaning(weaning failure group).The DE and DTF on both the left and right sides were compared between the two groups,the predictive efficacy of left and right DE and DTF for weaning failure was assessed.Results In the successful weaning group,the DE on the left side and right side,DTF on the left side and right side were significantly higher than those in the weaning failure group(all P＜0.05).ROC curve analysis revealed that the optimal cutoff values for predicting successful weaning of left and right DE were 9.50 mm and 11.05 mm,with sensitivity of 0.917 and 0.833 and specificity of 0.753 and 0.883,respectively.The optimal cutoff values for predicting successful weaning of left and right DTF were 20.60％and 19.75％,with sensitivity of 0.750 and 0.667 and specificity of 0.766 and 0.870,respectively.Conclusion Quantitative parameters measured by ultrasonography of the diaphragm can predict the outcome of weaning from mechanical ventilation in patients with type A aortic dissection after surgery with relatively high accuracy,which is worth promoting in clinical application.
国家科技期刊平台
NSTL
万方数据
