Sonographically Measured Improvement in Diaphragmatic Mobility and Outcomes Among Patients Requiring Prolonged Weaning from the Ventilator.
- Resource Type
- Academic Journal
- Authors
- Gibis N; Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany.; Schulz A; Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany.; Vonderbank S; Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany.; Boyko M; Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany.; Gürleyen H; Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany.; Schulz X; Department of Medical Statistics, University Medical Center Göttingen, Georg-August-Universität, Humboldtallee 32, 37073 Göttingen, Germany.; Bastian A; Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany.
- Source
- Publisher: Bentham Open Country of Publication: United Arab Emirates NLM ID: 101480481 Publication Model: eCollection Cited Medium: Print ISSN: 1874-3064 (Print) Linking ISSN: 18743064 NLM ISO Abbreviation: Open Respir Med J Subsets: PubMed not MEDLINE
- Subject
- Language
- English
- ISSN
- 1874-3064
Background: The need of prolonged weaning from the ventilator is a well-known predictor of an unfavorable patients` outcome. Diaphragmatic dysfunction is a serious problem for these patients. We wanted to determine the survival in patients who were already intubated for more than 4 weeks before they were admitted to our weaning unit. In this prospective study, we wanted to investigate if the diaphragmatic function could improve or was related to survival over an 18 months follow up period.
Methods: 84 patients were included when they were able to breathe at least 10 minutes over a t-piece and sit upright for at least 5 minutes. The diaphragmatic function was estimated sonographically using the up and downward movement of the lung silhouette. Sonographic follow-ups were performed for over 18 months. The survival rate, outcome and changes in diaphragm mobility were investigated.
Results: a) Survival: 49 patients (58%) survived the 18 months follow up period - 30 had a good outcome; 19 needed assistance. b) Survival in relation to diaphragm mobility: If diaphragmatic mobility improved ≥ 15.5 mm on the left side, the probability of survival was 94% with a probability of 76% to have a satisfying outcome.
Conclusion: Survival and outcome of prolonged weaning were significantly better when sonographically measured the mobility of left hemidiaphragm improved.
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