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Updated: Jul 16, 2025
Author Spotlight: Unraveling the Impact of Mechanical Ventilation on Diaphragm Function and Patient Outcomes
Published on: November 3, 2023
Is diaphragm ultrasound better than rapid shallow breathing index for predicting weaning in critically ill elderly
Berrin Er1, Başak Mızrak2, Aras Aydemir2
1Intensive Care Unit, University of Health Sciences Ankara Bilkent City Hospital, Ankara, Türkiye.
Introduction:
Prolonged weaning is associated with worse clinical outcomes in elderly patients. Beside traditional rapid shallow breathing index (RSBI), diaphragm ultrasound is a promising technique to evaluate the weaning process. We aimed to perform diaphragm ultrasonography for predicting the weaning process and its relation with frailty in the critically ill elderly population.
Materials And Methods:
We enrolled thirthy-two patients over 65 years of age who were mechanically ventilated for at least 48 hours. Thickness of diaphragm and excursion were evaluated within 48 h of intubation and during spontaneous breathing trial (SBT). Clinical parameters, frailty, diaphragm ultrasound results were compared according to the weaning status.
Results:
Mean age (standard deviation) was 79.3 ± 7.9 years, and 18 (56.3%) patients were classified as weaning failure. Diaphragmatic excursion during SBT was the only statistically significant parameter associated with weaning failure [2.37 cm (0.67) vs 1.43 cm (0.15), p= 0.0359]. There was no statistically significant difference regarding RSBI between the groups [70.5 (46) vs 127.5 (80), p= 0.09]. Baseline thickness of diaphragm and excursion at SBT were moderately correlated with frailty.
Conclusion:
Ultrasound can be used to show diaphragm dysfunction in the elderly frail population, and a multifactorial approach to the extubation process may include ultrasound instead of using traditional RSBI alone.
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