Diaphragmatic Ultrasound Indices in Correlation with Weaning Parameters for Detection and Prediction of Weaning Outcomes

Background: The use of diaphragmatic ultrasound in the intensive care unit is a technique of growing interest due to its portability, speed, and safety. Its use allows reporting on the structural and functional status of the diaphragm and can predict the probability of successful mechanical ventilator weaning. Patients on mechanical ventilation may have a multifactorial deterioration of diaphragmatic function that can lead to weaning failure and prolongation of invasive mechanical ventilation; therefore, assessing diaphragmatic function could help predict the patient’s ability to maintain spontaneous breathing over time. Aim and objectives: To correlate diaphragmatic ultrasound to weaning parameters for detection and prediction of weaning outcomes, diaphragmatic ultrasound parameters: measured by: ultrasound during spontaneous breathing trials(SBT), weaning failure causes: categorizing reasons for failure (e.g., diaphragmatic dysfunction, duration of mechanical ventilation: total duration of mechanical ventilation prior to weaning measured in days, and mortality rate: mortality associated with weaning outcomes. Patients and methods: This prospective randomized clinical study, include 48 patients were selected from attendee of Critical care and Emergency medicine Department of Al-Azhar University Hospitals from 15th November 2023 till 15th November 2024. Samples were collected by the systematic random method. Results: Both the PaO2/FIO2 ratio and the rapid shallow breathing index (RSBI) were positively correlated with DE-inspiratory. The ratio of RSBI to PaO2/FIO2 and DE-forced inspiration was positively correlated. The relationship between DTF, RSBI, and PaO2/FIO2 ratio was good. The pace of diaphragmatic contraction was negatively correlated with (RSBI and PaO2/FIO2 ratio). Conclusion: Significant improvements in key respiratory parameters, such as PaO2, PaCO2, and RSBI, alongside positive correlations with diaphragmatic function as measured by ultrasound. The gradual reduction in PaCO2 and the increase in PaO2 indicated improved respiratory efficiency and effective gas exchange, while diaphragmatic ultrasound findings provided valuable insights into the readiness for weaning.