Open AccessDiaphragmatic Function Assessed by Bed Side Ultrasonography in Patients with Sepsis or Septic Shock Admitted to Intensive Care Unit
Author(s) -
Ahmed Zaki,
Helmy Hassan El Ghawaby,
Mohamed Z. Gad,
Ismail Ahmed,
Amr Nawar
Publication year - 2021
Publication title -
open access macedonian journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.288
H-Index - 17
ISSN - 1857-9655
DOI - 10.3889/oamjms.2021.7060
Subject(s) - medicine , septic shock , diaphragmatic breathing , intensive care unit , mechanical ventilation , sepsis , diaphragm (acoustics) , shock (circulatory) , spontaneous breathing trial , ultrasound , weaning , prospective cohort study , surgery , radiology , physics , alternative medicine , pathology , acoustics , loudspeaker
BACKGROUND: Sepsis and septic shock are major problems faced the healthcare systems all over the world every year. The ultrasound (US) is a simple, non-invasive, easily accessible technique, and showed great accuracy in diaphragm assessment.AIM: We evaluated the diaphragmatic function assessed by US in patients with sepsis and septic shock and correlated these assessments with different parameters.MATERIALS AND METHODS: A prospective observational study carried out on 30 patients admitted to the intensive care unit (ICU) diagnosed with sepsis and/or septic shock. Both diaphragmatic excursion (DE) and thickness fraction (diaphragm thickening fraction [TDI] %) were assessed by US on admission and every 48 h along the patients’ ICU stay.RESULTS: In the current study, there was a statistically significant reverse relationship between mortality and the different diaphragmatic function parameters (DE on admission, average DE, on admission TDI%, average TDI%). On the other hand, the DE (on admission and average) showed a statistically significant reverse relation with the need and duration of mechanical ventilation (MV) while the TDI% showed a statistically significant reverse relation only with the duration of MV. Besides, there was a statistically significant direct relationship between successful weaning from MV and all the measured parameters.CONCLUSION: We proposed that the diaphragmatic function parameters (DE on admission, average DE, on admission TDI% and average TDI%) assessed by US of septic ICU patients could be used as a predictor of the need, duration, and successful weaning from MV and also as a predictor of mortality.