The 30-min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilation
PurposeThis study evaluated the 30-min diaphragm excursion change rate (ΔDE30–0) as a novel predictor of weaning success compared to existing parameters in patients with severe pneumonia requiring invasive mechanical ventilation.MethodsThis retrospective cohort study enrolled patients with severe pn...
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Frontiers Media S.A.
2025-05-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1595814/full |
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| author | Wentao Luo Huagen Zhang Yuchong Chen Wenfeng Luo Xiuwen Lin |
| author_facet | Wentao Luo Huagen Zhang Yuchong Chen Wenfeng Luo Xiuwen Lin |
| author_sort | Wentao Luo |
| collection | DOAJ |
| description | PurposeThis study evaluated the 30-min diaphragm excursion change rate (ΔDE30–0) as a novel predictor of weaning success compared to existing parameters in patients with severe pneumonia requiring invasive mechanical ventilation.MethodsThis retrospective cohort study enrolled patients with severe pneumonia requiring invasive mechanical ventilation (n = 100). The patients were divided into successful (n = 79) and failed (n = 21) extubation groups. Ultrasound measurements of diaphragm excursion (DE) were performed at baseline (DE0) and 30 min (DE30) during a spontaneous breathing trial. The ratio ΔDE30–0 was calculated as the absolute difference between DE30 and DE0 divided by DE0. Additional parameters including rapid shallow breathing index (Rapid Shallow Breathing Index, RSBI) and respiratory rate (RR) were also assessed. The predictive performance of ΔDE30–0 and other parameters was evaluated using receiver operating characteristic (ROC) curves.ResultsThe extubation failure group had significantly higher ΔDE30–0 (0.40 ± 0.20 vs. 0.14 ± 0.12, p < 0.0001), RSBI (59.62 ± 21.77 vs. 47.7 ± 13.6, p = 0.0025), and RR (23.62 ± 2.25 vs. 20.34 ± 2.18, p < 0.0001) compared to the success group. ΔDE30–0 demonstrated the highest predictive performance with an area under the ROC curve of 0.924, sensitivity of 86.1%, and specificity of 95.2% at a cut-off value of 0.209.ConclusionsΔDE30–0 is a promising predictor of weaning success in severe pneumonia patients requiring invasive mechanical ventilation. It outperformed existing parameters and demonstrated high predictive accuracy.Implications for clinical practiceIncorporating ΔDE30–0 into weaning protocols may improve decision-making, reduce complications, and optimize outcomes for patients requiring invasive mechanical ventilation due to severe pneumonia. This novel parameter can aid clinicians in identifying suitable candidates for extubation, potentially reducing the risk of weaning failure and associated adverse events. |
| format | Article |
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| institution | OA Journals |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-7a3d9642623c4b3a9a5f9de3f2d196252025-08-20T01:49:12ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15958141595814The 30-min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilationWentao Luo0Huagen Zhang1Yuchong Chen2Wenfeng Luo3Xiuwen Lin4Department of Critical Care Medicine III, Meizhou People’s Hospital, Meizhou, Guangdong, ChinaDepartment of Critical Care Medicine III, Meizhou People’s Hospital, Meizhou, Guangdong, ChinaDepartment of Critical Care Medicine I, Meizhou People’s Hospital, Meizhou, Guangdong, ChinaDepartment of Respiratory and Critical Care Medicine, Meizhou People’s Hospital, Meizhou, Guangdong, ChinaDepartment of Critical Care Medicine III, Meizhou People’s Hospital, Meizhou, Guangdong, ChinaPurposeThis study evaluated the 30-min diaphragm excursion change rate (ΔDE30–0) as a novel predictor of weaning success compared to existing parameters in patients with severe pneumonia requiring invasive mechanical ventilation.MethodsThis retrospective cohort study enrolled patients with severe pneumonia requiring invasive mechanical ventilation (n = 100). The patients were divided into successful (n = 79) and failed (n = 21) extubation groups. Ultrasound measurements of diaphragm excursion (DE) were performed at baseline (DE0) and 30 min (DE30) during a spontaneous breathing trial. The ratio ΔDE30–0 was calculated as the absolute difference between DE30 and DE0 divided by DE0. Additional parameters including rapid shallow breathing index (Rapid Shallow Breathing Index, RSBI) and respiratory rate (RR) were also assessed. The predictive performance of ΔDE30–0 and other parameters was evaluated using receiver operating characteristic (ROC) curves.ResultsThe extubation failure group had significantly higher ΔDE30–0 (0.40 ± 0.20 vs. 0.14 ± 0.12, p < 0.0001), RSBI (59.62 ± 21.77 vs. 47.7 ± 13.6, p = 0.0025), and RR (23.62 ± 2.25 vs. 20.34 ± 2.18, p < 0.0001) compared to the success group. ΔDE30–0 demonstrated the highest predictive performance with an area under the ROC curve of 0.924, sensitivity of 86.1%, and specificity of 95.2% at a cut-off value of 0.209.ConclusionsΔDE30–0 is a promising predictor of weaning success in severe pneumonia patients requiring invasive mechanical ventilation. It outperformed existing parameters and demonstrated high predictive accuracy.Implications for clinical practiceIncorporating ΔDE30–0 into weaning protocols may improve decision-making, reduce complications, and optimize outcomes for patients requiring invasive mechanical ventilation due to severe pneumonia. This novel parameter can aid clinicians in identifying suitable candidates for extubation, potentially reducing the risk of weaning failure and associated adverse events.https://www.frontiersin.org/articles/10.3389/fmed.2025.1595814/fullsevere pneumoniainvasive ventilationweaningdiaphragm ultrasoundpredictive index |
| spellingShingle | Wentao Luo Huagen Zhang Yuchong Chen Wenfeng Luo Xiuwen Lin The 30-min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilation Frontiers in Medicine severe pneumonia invasive ventilation weaning diaphragm ultrasound predictive index |
| title | The 30-min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilation |
| title_full | The 30-min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilation |
| title_fullStr | The 30-min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilation |
| title_full_unstemmed | The 30-min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilation |
| title_short | The 30-min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilation |
| title_sort | 30 min diaphragm movement change rate for predicting weaning success in severe pneumonia patients requiring invasive ventilation |
| topic | severe pneumonia invasive ventilation weaning diaphragm ultrasound predictive index |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1595814/full |
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