PT - JOURNAL ARTICLE AU - Savino Spadaro AU - Francesca Dalla Corte AU - Gaetano Scaramuzzo AU - Elisabetta Marangoni AU - Carlo Alberto Volta TI - Diaphragmatic ultrasonography during spontaneous breathing trials in critically ill patients: Can it identify weaning failure? AID - 10.1183/13993003.congress-2016.PA3560 DP - 2016 Sep 01 TA - European Respiratory Journal PG - PA3560 VI - 48 IP - suppl 60 4099 - http://erj.ersjournals.com/content/48/suppl_60/PA3560.short 4100 - http://erj.ersjournals.com/content/48/suppl_60/PA3560.full SO - Eur Respir J2016 Sep 01; 48 AB - Introduction: Monitoring respiratory muscles function is still an important issue during the weaning process. Beside traditional weaning parameters, M-mode diaphragmatic ultrasonography has been proposed as a valuable bedside tool to measure diaphragmatic displacement (DD).Aims and objectives: The aim of our study was to compare ultrasonographic DD with traditional weaning parameters in potentially ready to be extubated patients undergoing a spontaneous breathing trial (SBT).Methods: Acute respiratory failure patients ventilated for at least 24 hours were enrolled once resolved acute respiratory failure and once able to sustain an SBT. During the SBT, right hemi-diaphragm ultrasound scans were performed using a convex probe placed between the 8th and 10th intercostal space on the mid-axillary line. Simultaneously, non-forced spirometry was perfomed; finally, Maximum Inspiratory Pressure (MIP) was measured.Results: We enrolled 44 patients; 29 (66%) patients were successfully weaned after the SBT, while 10 (23%) were reconnected to mechanical ventilation after, 3 (7%) were reintubated within 48 hours and 2 (4%) required NIV support. We found a significant correlation between DD and MIP values (R2=0.63;p<0.001), VT (R2=0.43;p<0.001), RR (R2=0.25;p=0.001) and RSBI (R2=0.24;p=0.001). Among the other weaning indexes DD presented the highest AUC value (0.91, 80% sensibility, 86% specificity) in predicting weaning failure.Conclusions: Ultrasound measures of DD seems to predict weaning failure, especially when the reasons for failing the SBT cannot be explained by traditional parameters.