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ISSN: 1642-5758
Anaesthesiology Intensive Therapy
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vol. 54
Review paper

Diaphragm ultrasound to predict weaning outcome: systematic review and meta-analysis

Ata Mahmoodpoor
Shahnaz Fouladi
Ali Ramouz
Kamran Shadvar
Zohreh Ostadi
Hassan Soleimanpour

  1. Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  2. Department of Anesthesiology and Intensive Care Medicine, Ardabil University of Medical Sciences, Tabriz, Iran
  3. Department of General, Visceral and Transplant Surgery, Heidelberg University Hospital, Heidelberg, Germany
  4. Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Anaesthesiol Intensive Ther 2022; 54, 2: 164–174
Online publish date: 2022/06/21
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Proper timing for discontinuation of mechanical ventilation is of great importance, especially in patients with previous weaning failures. Different indices obtained by ultra­sonographic evaluation of the diaphragm muscle have improved determination of weaning success. The aim of the present systematic review was to evaluate and compare the accuracy of the diagnostic indices obtained by ultrasonographic examination, including diaphragm thickening fraction (DTF), diaphragmatic excursion (DE) and the rapid shallow breathing index (RSBI). A systematic literature search (Web of Science, MEDLINE, Embase and Google Scholar) was performed to identify original articles assessing diaphragm muscle features including excursion and thickening fraction. A total of 2738 citations were retrieved initially; available data of 19 cohort studies (1114 patients overall) were included in the meta-analysis, subdivided into groups based on the ultrasonographic examination type. Our results showed the superiority of the diagnostic accuracy of the DTF in comparison to the DE and the RSBI. Data on the combination of the different indices are limited. Diaphragmatic ultrasound is a cheap and feasible tool for diaphragm function evaluation. Moreover, DTF in the assessment of weaning outcome provides more promising outcomes, which should be evaluated more meti­culously in future randomised trials.

mechanical ventilation, weaning, diaphragm dysfunction, diaphragmatic excursion

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