GIÁ TRỊ CỦA CHỈ SỐ THỞ NHANH NÔNG CƠ HOÀNH TRONG DỰ ĐOÁN KẾT QUẢ CAI THỞ MÁY Ở BỆNH NHÂN THÔNG KHÍ NHÂN TẠO XÂM NHẬP

Abstract

Objective: To evaluate the predictive value of the Diaphragmatic Rapid Shallow Breathing Index (D-RSBI) for weaning outcomes in patients undergoing invasive mechanical ventilation. Subjects: Patients indicated for weaning from mechanical ventilation at the Center for Critical Care Medicine of Bach Mai Hospital from July 2023 to August 2024. Method: Prospective descriptive study. Eligible patients who met the criteria for weaning from mechanical ventilation were subjected to weaning. Respiratory rate and diaphragmatic ultrasound index were collected 30-60 minutes after the initiation of weaning, and the D-RSBI index was calculated. Diaphragmatic ultrasound was performed using a convex and linear probe ultrasound machine by a physician with ultrasound certification, video made and verified by radiologist. Results: 33 patients were recruited in the study. The male-to-female ratio was twice as high in males compared to females. Clinical and paraclinical indices showed no statistically significant differences. The success rate of weaning was 42.4% (n=14), with inadequate cough being the primary reason for failure, accounting for 63.2% (n=12). Compared to RSBI, NIF, Vt, and P_0.1, the D-RSBI index had a higher prognostic value for weaning failure. The AUC, Se, Sp, PPV, and NPV for the DE-RSBI on the right were 0.966; 89.5; 100; 89.47; 87.50, respectively; DTF-RSBI on the right were 0.814; 94.7; 64.3; 94.73; 90.00, respectively; DE-RSBI on the left were 0.900; 73.7; 92.9; 73.68; 72.22 respectively; DTF-RSBI on the left were 0.726; 52.6; 92.9; 52.63; 59.09, respectively. There was only a linear correlation between the D-RSBI indies and other weaning prediction indices. Conclusion: The D-RSBI index has high value in predicting weaning failure.