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CLINICAL TRIAL article

Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1449938
This article is part of the Research Topic Cutting Edge Advances in Medical Image Analysis and Processing View all articles

Speckle tracking ultrasound as a new tool to predict the weaning outcome of mechanical ventilation patients: a prospective observational study

Provisionally accepted
Rui Li Rui Li *Yao Zhou Yao Zhou Wan Chen Wan Chen *Li-Wen Lyu Li-Wen Lyu *Guozheng Qiu Guozheng Qiu *Chunxi Pan Chunxi Pan *Yutao Tang Yutao Tang *
  • People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China

The final, formatted version of the article will be published soon.

    Introduction Speckle tracking ultrasound is a novel technique for evaluating diaphragm movement, yet its guidance in weaning mechanically ventilated patients remains unclear. In this study, we assessed diaphragmatic function using speckle tracking ultrasound and guided the weaning process.Methods: A total of 86 mechanically ventilated patients were included and divided into successful or failed weaning groups. Diaphragmatic function was assessed using speckle tracking ultrasound, M-ultrasound diaphragm excursion (DE), and diaphragmatic twitch force (DTF) after 30 minutes spontaneous breathing trial (SBT). The diagnostic performance of these indicator in predicting weaning outcomes was also evaluated.In this study, a total of 86 patients completed the follow-up for weaning outcomes, with 35 cases of weaning failure and 51 cases of successful weaning. Logistic regression analysis identified whole strain (p=0.037) and DE (p=0.004) as independent predictors of weaning outcome. Receiver operating characteristic (ROC) curve showed that the strain threshold for Costal Diaphragm (Dlcos) was -9.836, Area Under the Curve (AUC) value was 0.760, the predictive specificity for weaning failure was 72.5%, and the sensitivity was 80%. DE value exceeding 1.015 cm had an AUC value of 0.785, noting that DE value had a high specificity (90.2%) for predicting successful weaning, but a lower sensitivity (60%). After merging, the AUC of whole strain and DE was 0.856, and the sensitivity (80%) and specificity (80.4%) were more balanced compared to using DE alone.The findings of this study demonstrate the feasibility of using speckle tracking ultrasound to assess diaphragmatic function in mechanically ventilated patients. The combined utilization of whole strain and DE provides a more precise evaluation of diaphragmatic function in ICU patient, which may improve patient outcome.

    Keywords: mechanical ventilation, Diaphragmatic function, Speckle tracking ultrasonography, Outcome, Weaning

    Received: 16 Jun 2024; Accepted: 19 Nov 2024.

    Copyright: © 2024 Li, Zhou, Chen, Lyu, Qiu, Pan and Tang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Rui Li, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
    Wan Chen, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
    Li-Wen Lyu, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
    Guozheng Qiu, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
    Chunxi Pan, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
    Yutao Tang, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China

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