Usefulness of diaphragmatic ultrasound in predicting extubation success

Objective: To evaluate the diagnostic accuracy of diaphragmatic ultrasound in predicting extubation success. Design: A diagnostic accuracy study was carried out. Scope: Intensive Care Unit of an Academic hospital in the city of Bogota (Colombia). Patients or participants: A consecutive sample of patients > 18 years of age subjected to invasive mechanical ventilation for > 48 h. Interventions: Diaphragmatic ultrasound evaluation at the end of spontaneous ventilation testing. Main variables of interest: Diaphragmatic excursion (DE, cm), inspiration time (TPIA(dia), s), diaphragm contraction speed (DE/TPIA(dia), cm/s) and total time (Ttot, s) were evaluated, together with thickening fraction (TFdi, %). Results: A total of 84 patients were included, 79.8% (n = 67) with successful extubation and20.2% (n = 17) with failed extubation. The variable with the best discriminatory capacity inpredicting extubation success was diaphragm contraction speed, with AUC-ROC 0.70 (p = 0.008). Conclusions: Diaphragm contraction speed exhibited acceptable discriminatory capacity. Ultrasound could be part of a multifactorial approach in the extubation process. (c) 2019 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.