A Prospective Observational Study to Assess the Role of Lung Ultrasound for Predicting Weaning Outcome in Intensive Care Unit Patients Using Lung Ultrasound Score and Diaphragm Thickening Fraction
Richa Tiwari, Rahul Chauhan, Nupur B. PatelBackground:
Weaning from mechanical ventilation is a critical phase in the care of intensive care unit (ICU) patients. Accurate prediction of weaning success is essential for patient outcomes. Ultrasound evaluation of diaphragm function and lung aeration has gained attention as a potential predictor. This study aimed to assess the role of ultrasound in predicting weaning outcomes, comparing diaphragm thickening fraction (DTF) and lung ultrasound score (LUS).
Methodology:
This study was conducted in a tertiary care ICU from November 2019 to December 2021, involving 80 mechanically ventilated patients. The study assessed age, sex, ICU stay duration, and mechanical ventilation duration in two groups: those successfully extubated and those who failed weaning. Ultrasound measurements of DTF and lung aeration (LUS) were obtained and analyzed.
Results:
Age and sex did not significantly differ between the groups, but the duration of ICU stay and mechanical ventilation differed markedly, with patients who failed weaning having longer stays in both. DTF emerged as a significant predictor of weaning success, with a cutoff value of 32.5% showing high sensitivity (92.9%) and specificity (86.8%). LUS also demonstrated predictive power, with a sensitivity of 83.3% and specificity of 86.8% when using a cutoff value of 8.5. DTF outperformed LUS with a slightly higher AUC (0.978 vs. 0.943) and greater sensitivity.
Conclusion:
This study highlights the value of ultrasound assessment in predicting weaning outcomes for mechanically ventilated patients. Both DTF and LUS proved to be significant predictors of weaning success. These noninvasive, bedside ultrasound techniques can assist clinicians in making informed decisions during the weaning process. Ultimately, the results suggest that early identification of patients at risk of weaning failure can reduce mechanical ventilation duration and improve ICU patient outcomes.