Diaphragmatic excursion time index as a predictor of extubation in intensive therapy

Authors

  • Salvador Domínguez-Estrada <p>Instituto Mexicano del Seguro Social, Hospital Regional No. 58, Servicio de Terapia Intensiva. Le&oacute;n, Guanajuato, M&eacute;xico.</p> http://orcid.org/0009-0002-4605-9094
  • Edgar Bravo-Santibañez <p>Instituto Mexicano del Seguro Social, Unidad M&eacute;dica de Alta Especialidad N&deg; 1 Baj&iacute;o, Servicio de Terapia Intensiva. Le&oacute;n, Guanajuato. M&eacute;xico.&nbsp;</p> http://orcid.org/0000-0003-1553-573X
  • Xóchilt Ramos-Ramos <p>Instituto Mexicano del Seguro Social, &Oacute;rgano de Operaci&oacute;n Administrativa Desconcentrada, Coordinador&nbsp;Auxiliar M&eacute;dico de Investigaci&oacute;n en Salud. Le&oacute;n, Guanajuato, M&eacute;xico.</p> http://orcid.org/0000-0002-2161-826X
  • José Sergio López-Briones <p>Universidad de Guanajuato, Direcci&oacute;n en Ciencias M&eacute;dicas, Laboratorio de Biolog&iacute;a Molecular. Le&oacute;n, Guanajuato, M&eacute;xico .</p> http://orcid.org/0000-0003-0273-0958

DOI:

https://doi.org/10.5281/zenodo.11396976

Keywords:

Critical Care, Ultrasonics, Diaphragm, Artificial Respiration

Abstract

Background: Extubation is a critical process in the ICU. Pulmonary USG has different applications, those that predict success in extubation, such as the diaphragmatic excursion time index (DEIT).

Objective: To determine the diaphragmatic excursion time index is a predictor of the success of weaning off mechanical ventilation in patients in the intensive care unit.

Material and methods: Diagnostic performance study in patients in the ICU and in the extubation protocol. Diaphragmatic measurement by USG, evaluating DEIT; cut-off point of 2.42 ± 1.55 cm/s. In the hypothesis test, a JI square was carried out between the two qualitative variables, in order to accept or reject H0, with a statistical significance of p < 0.05 to determine if there is dependence between the dependent and independent variables.

Results: Total of 200 patients from the population, with successful extubation in 52.5% and extubation failure in 47.5%. Prognostic values of the DEIT were: S: 77.1% (68.2-84.1%), E: 56.8% (46.8-66.3%). ROC curve for ITED, AUC of 0.665 (0.58-0.74; p = 0.001). In secondary objectives, a correlation was made between ventilatory and demographic variables for successful extubation; with FvT (Rho: 0.680, p = 0.0001).

Conclusions: The DEIT for withdrawal of mechanical ventilation has low sensitivity and specificity as a result of successful extubation. The finding that DEIT is not an adequate predictor determining the outcome of successful extubation.

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Author Biographies

  • Salvador Domínguez-Estrada, <p>Instituto Mexicano del Seguro Social, Hospital Regional No. 58, Servicio de Terapia Intensiva. Le&oacute;n, Guanajuato, M&eacute;xico.</p>

    Instituto Mexicano del Seguro Social, Hospital Regional 58, Servicio de Terapia Intensiva. León, Guanajuato, México. 

    Médico adscrito a la terapia intensiva en turno nocturno.

  • Edgar Bravo-Santibañez, <p>Instituto Mexicano del Seguro Social, Unidad M&eacute;dica de Alta Especialidad N&deg; 1 Baj&iacute;o, Servicio de Terapia Intensiva. Le&oacute;n, Guanajuato. M&eacute;xico.&nbsp;</p>

    Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad 1 Bajío, UMAE T1, Servicio de Terapia Intensiva. León, Guanajuato. México. 

  • Xóchilt Ramos-Ramos, <p>Instituto Mexicano del Seguro Social, &Oacute;rgano de Operaci&oacute;n Administrativa Desconcentrada, Coordinador&nbsp;Auxiliar M&eacute;dico de Investigaci&oacute;n en Salud. Le&oacute;n, Guanajuato, M&eacute;xico.</p>

    Instituto Mexicano del Seguro Social, Coordinador auxiliar medico de investigación en salud, Órgano de Operación Administrativa Desconcentrada. León, Guanajuato, México.

  • José Sergio López-Briones, <p>Universidad de Guanajuato, Direcci&oacute;n en Ciencias M&eacute;dicas, Laboratorio de Biolog&iacute;a Molecular. Le&oacute;n, Guanajuato, M&eacute;xico .</p>

    Director en Ciencias Médicas Universidad de Guanajuato, Laboratorio de Biología Molecular. León, Guanajuato, México.

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Published

2024-07-18

Issue

Vol. 62 No. 4 (2024): July-August

Section

Original Articles

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