Diaphragmatic Ultrasound Parameters as Predictors of Weaning Success in Cervical Spinal Cord Injury

BACKGROUND This study explored the performance of bedside ultrasound monitoring of diaphragmatic function in predicting the ventilator weaning outcomes of patients with cervical spinal cord injury. MATERIAL AND METHODS The clinical data of 136 eligible patients hospitalized from December 2021 to December 2023 were obtained for this prospective study, and they were assigned into weaning failure and weaning success groups. Intergroup comparisons were conducted on the general data and diaphragmatic function parameters: diaphragm excursion (DE), diaphragm thickening fraction (DTF), diaphragm contraction velocity (DCV), diaphragmatic-shallow rapid breathing index (D-RSBI), diaphragmatic thickness at the end of expiration (DTee), and diaphragmatic thickness at the end of inspiration (DTei). RESULTS Among the diaphragmatic function parameters, decreases in DE and DTF but increases in DCV and D-RSBI were observed in the weaning failure group compared with those in the weaning success group (P<0.05). There were no significant differences in DTei and DTee between the 2 groups (P>0.05). The areas under the receiver operating characteristics (ROC) curves of DE, DTF, DCV, and D-RSBI alone and their combination for predicting ventilator weaning outcomes were all >0.70, and the combination had the highest predictive value. The combination of DE, DTF, DCV, and D-RSBI was superior to the 4 parameters alone in terms of the net benefit for predicting ventilator weaning outcomes in the threshold ranges of 0-0.842, 0.843-0.878, and 0.907-1.000. CONCLUSIONS Bedside ultrasound monitoring of diaphragmatic function parameters DE, DTF, DCV, and D-RSBI has good predictive value for the ventilator weaning outcomes of patients with cervical spinal cord injury.