About: The Utility of Diaphragm Ultrasound in Reducing Time to Extubation

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	The Utility of Diaphragm Ultrasound in Reducing Time to Extubation
Creator	Dennis Mccool, F Dennis, · Koo, · Oyieng'o, O
source	PMC
abstract	PURPOSE: Prediction of optimal timing for extubation of mechanically ventilated patients is challenging. Ultrasound measures of diaphragm thickness or diaphragm dome excursion have been used to aid in predicting extubation success or failure. The aim of this study was to determine if incorporating results of diaphragm ultrasound into usual ICU care would shorten the time to extubation. METHODS: We performed a prospective, randomized, controlled study at three Brown University teaching hospitals. Included subjects underwent block randomization to either usual care (Control) or usual care enhanced with ultrasound measurements of the diaphragm (Intervention). The primary outcome was the time to extubation after ultrasound, and the secondary outcome was the total days on the ventilator. Only intensivists in the Intervention group would have the ultrasound information on the likelihood of successful extubation available to incorporate with traditional clinical and physiologic measures to determine the timing of extubation. RESULTS: A total of 32 subjects were studied; 15 were randomized into the Control group and 17 into the Intervention group. The time from ultrasound to extubation was significantly reduced in the Intervention group compared to the Control group in patients with a ∆tdi% ≥ 30% (4.8 ± 8.4 vs 35.0 ± 41.0 h, p = 0.04). The time from ultrasound to extubation was shorter in subjects with a normally functioning diaphragm (∆tdi% ≥ 30%) compared to those with diaphragm dysfunction (∆tdi% < 30%) (23.2 ± 35.2 vs 57.3 ± 52.0 h p = 0.046). When combining the Intervention and Control groups, a value of ∆tdi% ≥ 30% for extubation success at 24 h provided a sensitivity, specificity, PPV and NPV of 90.9%, 86.7%, 90.9%, and 86.7%, respectively. CONCLUSIONS: Diaphragm ultrasound evaluation of ∆tdi% aids in reducing time to extubation.
has issue date	2020-04-13(xsd:dateTime)
bibo:doi	10.1007/s00408-020-00352-3
bibo:pmid	32285195
has license	no-cc
sha1sum (hex)	58a67006c187916768a0876686317302756fed3f
schema:url	https://doi.org/10.1007/s00408-020-00352-3
resource representing a document's title	The Utility of Diaphragm Ultrasound in Reducing Time to Extubation
has PubMed Central identifier	PMC7222069
has PubMed identifier	32285195
schema:publication	Lung
resource representing a document's body	covid:58a67006c187916768a0876686317302756fed3f#body_text
is schema:about of	named entity 'ultrasound' named entity 'ICU' named entity 'care' named entity 'Control group' named entity 'subjects' named entity 'extubation' named entity 'Intervention' named entity 'randomized' named entity 'AID' named entity 'INTERVENTION' named entity 'DETERMINE' named entity 'CONCLUSIONS' named entity 'INTERVENTION GROUP' named entity 'prospective' named entity 'aids' named entity 'measures' named entity 'ultrasound' named entity 'aim' named entity 'reducing' named entity 'Intervention' named entity 'predicting' named entity 'compared' named entity 'optimal' named entity 'group' named entity 'diaphragm' named entity 'time' named entity 'extubation' named entity 'subjects' named entity 'tdi' named entity 'determine' named entity 'extubation' named entity 'diaphragm' named entity 'ultrasound' named entity 'mechanically ventilated' named entity 'ultrasound' named entity 'ultrasound' named entity 'NPV' named entity 'diaphragm' named entity 'extubation' named entity 'diaphragm' named entity 'extubate' named entity 'intercostal space' named entity 'extubation' named entity 'tdi' named entity 'extubation' named entity 'spontaneous breathing trial' named entity 'intensivist' named entity 'intensivist' named entity 'extubation' named entity 'control group' named entity 'Ultrasound' named entity 'diaphragm' named entity 'rapid shallow breathing index' named entity 'NPV' named entity 'extubation' named entity 'skilled nursing' named entity 'oxygen saturation' named entity 'extubation' named entity 'diaphragm' named entity 'extubation' named entity 'mechanical ventilation' named entity 'diaphragm' named entity 'mechanical ventilation' named entity 'extubation' named entity 'extubation' named entity 'rib cage' named entity 'Brown University' named entity 'diaphragm' named entity 'diaphragm' named entity 'ultrasound' named entity 'diaphragm' named entity 'diaphragm' named entity 'diaphragm' named entity 'extubation' named entity 'NPV' named entity 'ultrasound' named entity 'ultrasound' named entity 'ultrasound'

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