ĐÁNH GIÁ VAI TRÒ CỦA SIÊU ÂM CƠ HOÀNH TRONG TIÊN LƯỢNG CAI THỞ MÁY TẠI KHOA CẤP CỨU VÀ HỒI SỨC TÍCH CỰC BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

The study was conducted on 40 patients on mechanical ventilation who met the criteria for weaning from mechanical ventilation, being treated at the Emergency and Intensive Care Department of Hanoi University of Medicine from July 2023 to July 2024, using a prospective cross-sectional descriptive method to evaluate the role of diaphragm ultrasound in predicting weaning outcomes in this patient group. The results of the study indicate that diaphragm ultrasound plays a role in predicting a high likelihood of weaning failure, especially when used in conjunction with clinical factors. The diaphragm excursion (DE) and diaphragm thickness fraction (DTF) ultrasound indices have sensitivities and specificities of 60%, 100% and 88.6%, 100%. When these two indices are combined with the patient's respiratory rate (RR) during the weaning process, they create two new indices: the rapid shallow breathing index combined with diaphragm excursion (DE-RSBI). The rapid shallow breathing index with diaphragm thickness fraction (DTF-RSBI) can predict weaning failure from mechanical ventilation better than the simple rapid shallow breathing index (RSBI), with areas under the curve (AUC) of 0.937, 0.92, and 0.889, respectively. Therefore, it can be concluded that diaphragm ultrasound plays an important role in predicting weaning from mechanical ventilation, and it is necessary to combine clinical assessment with diaphragm ultrasound to achieve a higher effectiveness in predicting weaning than using clinical factors alone.