scholarly journals Role of diaphragmatic rapid shallow breathing index in predicting weaning outcome in patients with acute exacerbation of COPD

2018 ◽  
Vol Volume 13 ◽  
pp. 1655-1661 ◽  
Author(s):  
Ahmad Abbas ◽  
Sameh Embarak ◽  
Mohammad Walaa ◽  
Samah Lutfy
Keyword(s):  
Acute Exacerbation ◽  
Acute Exacerbation Of Copd ◽  
Rapid Shallow Breathing Index ◽  
Shallow Breathing ◽  
Exacerbation Of Copd ◽  
Weaning Outcome ◽  
Rapid Shallow Breathing

ROLE OF INFLAMMATORY MEDIATORS AS MARKERS OF SEVERITY AND OUTCOME IN ACUTE EXACERBATION OF COPD

CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 480A ◽  
Author(s):  
Anant Mohan ◽  
Randeep Guleria ◽  
Charu Mohan ◽  
Surya P. Bhatt ◽  
Sneh Arora ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Inflammatory Mediators ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

scholarly journals Ventilator induced Diaphragmatic Dysfunction assessed by Ultrasonography and its impact on Weaning outcome

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M A Fawzy ◽  
M H M Hassan ◽  
A A M Alkholy
Keyword(s):  
Mechanical Ventilation ◽  
Operating Characteristics ◽  
Diaphragmatic Dysfunction ◽  
Rapid Shallow Breathing Index ◽  
Weaning Failure ◽  
Significant Difference ◽  
Shallow Breathing ◽  
Ventilation Modes ◽  
Weaning Outcome ◽  
Rapid Shallow Breathing

Abstract Background Ventilator induced diaphragmatic dysfunction (VIDD), as a loss of diaphragmatic force generating capacity due to the use of mechanical ventilation. Difficulties in discontinuing ventilatory support are encountered in 20–25% of mechanically ventilated patients, with a staggering 40% of time spent in the intensive care unit being devoted to weaning. M-mode ultrasonography is now an accepted qualitative method of assessing diaphragmatic motion in normal and pathological conditions. In this study, we evaluated whether diaphragmatic excursion (DE) as measured by M-mode sonography can be a predictor of weaning and diagnosis of VIDD. Aim The aim of this study is to determine the presence of ventilator induced diaphragmatic dysfunction (VIDD) diagnosed by M-mode ultrasonography and its impact on weaning outcome. Methodology This study was conducted prospectively in critical care unit in Ain Shams Hospital, a university-affiliated, tertiary referral center in Cairo, Egypt. Study subjects included 78 patients between August 2017 to August 2018. who required mechanical ventilation ≥72hrs. who fulfilled the spontaneous breath trial (SBT) criteria, at the start of a 1-hr SBT, each hemidiaphragm was evaluated M-mode sonography with the patient in the supine position. Rapid shallow Breathing index (RSBI) was simultaneously calculated at the bedside. Ultrasonographic Diaphragmatic Dysfunction (DD) was diagnosed if an Diaphragmatic Excursion (DE) was <10 mm or negative, the latter indicating paradoxical diaphragmatic movement. Results Diaphragmatic Dysfunction (DD) among the eligible 78 patients was 48% (n = 37). DD group had longer weaning time [39,2 (26-56) hrs. vs. 22.3 (30-16) hrs. p = 0.001) in DD vs. NDD group respectively and total ventilation time [140 (130-150) hrs. vs. 130 (120–140) hrs. p > 0.05) in DD vs. NDD group respectively. Weaning failure was (45.8% vs. 30.8%, p=0.01) in DD vs. NDD group respectively. In NDD group Rt. DE, mean 25.4 ±4.1 mm. While Lt. side was 25.3±4.6 mm, 11.25mm and 22mm (45-15) respectively. In DD group Rt. DE, mean 7.6 ±2.02mm, IQR 2.4 mm and median 8.2mm (10-1.9). While Lt. side was 9.2±0.8mm, 4.3mm and 8.9mm (9.8-5.7) respectively. The area under the receiver operating characteristics curve (ROC) of ultrasonographic criteria in predicting weaning failure was near similar to that of rapid shallow breathing index. Hypercapenic acidosis in NDD group might protect them from VIDD Conclusions DD is present in a significant percentage 48% (nearly half) of our medical ICU patients on MV ≥ 72 hrs which largely account for weaning failure. DD was associated with a significant longer weaning time, and ICU stay, with no significant difference in 30 day mortality Recommendations DE by US measurements is a valuable tool and is recommended as an adjunctive weaning index to aid prediction of weaning outcome. Evaluating the role of spontaneous ventilation modes and advanced ventilation modes as PAV and NAVA effects on decreas ing VIDD versus controlled modes.

Serial Measurements of the Rapid-Shallow-Breathing Index as a Predictor of Weaning Outcome in Elderly Medical Patients

CHEST Journal ◽  
1997 ◽  
Vol 112 (4) ◽  
pp. 1029-1034 ◽  
Author(s):  
Bruce P. Krieger ◽  
Jamal Isber ◽  
Albe Breitenbucher ◽  
Georgene Throop ◽  
Patti Ershowsky
Keyword(s):  
Medical Patients ◽  
Rapid Shallow Breathing Index ◽  
Shallow Breathing ◽  
Weaning Outcome ◽  
Serial Measurements ◽  
Rapid Shallow Breathing

scholarly journals Can diaphragmatic ultrasonography performed during the T-tube trial predict weaning failure? The role of diaphragmatic rapid shallow breathing index

Critical Care ◽  
2016 ◽  
Vol 20 (1) ◽  
Author(s):  
Savino Spadaro ◽  
Salvatore Grasso ◽  
Tommaso Mauri ◽  
Francesca Dalla Corte ◽  
Valentina Alvisi ◽  
...  
Keyword(s):  
T Tube ◽  
Rapid Shallow Breathing Index ◽  
Weaning Failure ◽  
Shallow Breathing ◽  
Rapid Shallow Breathing

scholarly journals ROLE OF PNEUMONIA SEVERITY INDEX AND CURB-65 SCORE IN PATIENTS WITH ACUTE EXACERBATION OF COPD WITH REFERENCE TO THEIR DURATION OF HOSPITAL STAY

2020 ◽  
Vol 8 (10) ◽  
pp. 955-966
Author(s):  
Pankaj Kumar Singh ◽  
◽  
Mohit Bhatnagar ◽  
Sandeep Nimba Deore ◽  
Mandeep Joshi ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Acute Exacerbation ◽  
Tertiary Care ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Pneumonia Severity ◽  
Acute Exacerbation Of Copd ◽  
Duration Of Hospital Stay ◽  
Exacerbation Of Copd

Aim and Objective: To investigate the role of Pneumonia Severity Index and CURB-65 score in patients with acute exacerbation of COPD with reference to Duration of hospital stay. Methods:In our study a total of 100 patients of COPD with acute exacerbation were included in the study from the tertiary care Centre, Kolkata for a period of 12 months from December 2015 to November 2016. Results: The relationship between Respiratory rate, Arterial pH, Urea and BUN levels, Blood glucose, Hematocrit level, pO2 as well as PSI and CURB-65 score in reference with duration of hospital was found to be significant. Our study revealed that PSI and CURB-65 score have good predictive capacity for in hospital deaths as well as duration of hospital stay. Conclusion: PSI and CURB -65 can predict the duration of hospital stay, with a good prognostic capacity. The role of PSI and CURB-65 in defining duration of hospital stay needs to be assessed by further studies on larger samples using Indian data for reference value. The present study is a stimulus to future research on role of PSI, CURB-65 as well as comorbidities in defining the outcome of acute exacerbations in COPD, one of the most dreaded respiratory diseases.

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