膈肌超声在新生儿机械通气撤机中的预测价值OA

Objective:To investigate the predictive value of diaphragmatic ultrasound parameters for successful weaning from mechanical ventilation in neonates.Methods:Seventy mechanically ventilated neonates were prospectively enrolled.Prior to weaning,diaphragmatic excursion(DE),diaphragm thickening fraction(DTF),and diaphragmatic excursion-time index(E-T)were measured by ultrasound.According to the need for re-intubation within 48 h after weaning,the infants were divided into success and failure groups.Intergroup differences were compared.Univariate and multivariate logistic regression analyses were performed to identify independent predictors,and receiver operating characteristic(ROC)curves were constructed to assess the predictive performance of individual and combined parameters.Results:DE,DTF,and E-T were significantly higher in the success group compared with the failure group(P＜0.05).The areas under the curve(AUC)for predicting weaning success were 0.740 for DE,0.844 for DTF,and 0.684 for E-T.Logistic regression analysis identified all three parameters as independent predictors.Combined model analysis showed that the AUCs for DE combined with DTF and E-T combined with DTF were 0.923 and 0.892.Conclusion:DE,DTF,and E-T are reliable predictors of successful weaning from mechanical ventilation in neonates.Among them,E-T,as a novel indicator reflecting diaphragmatic contractile efficiency,has considerable clinical utility.The combined application of parameters further enhances predictive accuracy.