Ultrasound and diaphragmatic dysfunction: impact of surgical approach
M Luperto, M Bouard, S Mongodi, F Mojoli, B Bouhemad
Critical Care 2018, 22(Suppl 1):P211
Introduction: Diaphragm ultrasound (DUS) easily identifies diaphragmatic dysfunction (DD) in ICU patients , a potential cause of weaning failure (WF).
Methods: Prospective observational monocenter study. We enrolled adults ICU patients at day 1 after surgery, extubated, with no neuromuscolar diseases. In each patient DUS (caudal displacement (CD) and thickening fraction (TF)), was performed. WF was defined as NIV or reintubation within 48h after extubation.
Results: We enrolled 43 patients (25 males, age 70.9±10.2 years, BMI 27.1±5, MV length 5h [4-6], ICU stay 1.5 days [1.0-2.0]). Surgery was performed by laparotomy (La-28%), sternotomy (St-53%) or right thoracotomy (Rt-19%). No differences were remarked in patients’ characteristics, MV length, ICU stay Table 1. Rt patients had WF more than other approaches (p=0.0080); right CD and TF were significantly lower in Rt (p<0.05, Table 2). Rt was a risk factor for WF (OR 17.5, 95% CI 1.38-222.62, p=0.0024).
Conclusions: Postsurgical right DD is significantly affected by surgical approach; Rt has the highest percentage of DD, probably explaining the highest rate of WF.
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2. Umbrello M et al. Respir Care 2016 P212