床旁肺部超声在重症患者机械通气脱机评估中的应用价值

doi:10.3969/j.issn.1002-1949.2017.11.008

Chinese Journal of Critical Care Medicine

The value of bedside lung ultrasound evaluation during the weaning from mechanical ventilation in ICU patients

Yang Min, Li Hui, Yin Lu, Zhang Pin-jie

Department of Intensive Care Unit, No. 2 Hospital Affiliated to Anhui Medical University, Hefei 230601, China

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Abstract Objective: To investigate the value of bedside lung ultrasound（BLU） in the weaning from mechanical ventilation（MV） in ICU patients, especially the dynamic monitoring changes of pulmonary lesions and diaphragmatic function. Methods: We prospectively selected 28 cases of mechanically ventilated patients in accordance with the inclusion criteria from March 2016 to September 2016. At the beginning of the spontaneous breathing test after fifteen minutes, the authorized ICU doctors assessed indicators of pulmonary lesions and diaphragmatic function in mechanically ventilated patients by BLU, to help guide the weaning process. Results: ①In this study, the success rate of weaning was 89.29% (25/28). The 3 cases of weaning failure were closely related to ventilator-induced diaphragmatic dysfunction; 2 cases died after discharged without treatment; and 1 case survived after treatment. ②Diaphragmatic function (diaphragm excursion, the thickness of the diaphragm and diaphragm thickening fraction) had significant negative correlation with rapid shallow breathing index and the duration of ventilation (P＜0.05). There was no obvious correlation between the APACHE Ⅱ score, age and other factors (P＞0.05). Conclusion: This study indicated that the duration of MV is closely related to the degree of diaphragmatic function injury. Ventilator-induced diaphragmatic dysfunction significantly increases the duration of ventilation and mortality in mechanically ventilated patients. The combination of BLU and rapid shallow breathing index can effectively guide the evaluation of weaning process in mechanically ventilated patients.

Received: 28 April 2017

About author:: Yang Min, E-mail: 456ym@163.com

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	Yang Min
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Yang Min,Li Hui,Yin Lu, et al. The value of bedside lung ultrasound evaluation during the weaning from mechanical ventilation in ICU patients[J]. Chinese Journal of Critical Care Medicine, 2017, 37(11): 1000-1004.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2017.11.008 OR http://www.cnemergency.org.cn/EN/Y2017/V37/I11/1000

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