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EVALUATION OF DIAPHRAGMATIC ULTRASONOGRAPHY AS ONE OF THE CRITERIA OF DISCONTINUATION OF MECHANICAL VENTILATION

Background: Weaning process is a key element of mechanical ventilation, occupying up to 50% of its total duration. The diaphragm is the principal respiratory muscle, and its dysfunction predisposes to respiratory complications and can prolong the duration of mechanical ventilation. Aim of the Work: to evaluate ultrasound derived measurements of diaphragmatic thickness as one of the criteria for discontinuation of mechanical ventilation. Patients and Methods: The study was carried out on 60 intubated ventilated patients with various causes of respiratory failure who were on invasive mechanical ventilation. When planning for the weaning and extubation the patient was randomly allocated into one of the two groups: Control Group (C) upon which traditional criteria for weaning was used and Study Group (S) the same traditional criteria was used also and (Δ tdi%) ≥ 30% was used as a reference for extubation. Results: There was non significant difference as regarding demographic variables, mortality, causes of mechanical ventilation and hemodynamics after extubation. However a significant difference between two groups was detected regarding reintubation with p value 0.0326. Also, there was a significant difference regarding days of mechanical ventilation with p value 0.001. Conclusion: Ultrasound derived measurements of diaphragmatic thickness can be used as one of the criteria for discontinuation of mechanical ventilation but needs further wide scale studies.