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Is There Impact In The Diaphragm Thickness Verified Through The Ultrasonography On The Critical Patient’s Weaning?

Ramon Paredes, Luciana Figueiredo, Luiza Silva, Jardiel Silva, Rodrigo Tonella, Antonio Falcão, Ligia Ratti, Lidiane Souza

LEARNING OBJECTIVES

To apply a protocol for analyzing the diaphragmatic thickness by ultrasonography, during weaning of mechanical ventilation in tracheostomized patients in Intensive Critical Care.

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METHODOLOGY

The first evaluation was perform at first spontaneous breathing trial and daily until 48 hours without mechanical ventilation.

The examination was performed in B mode with a linear transductor. The measurement was performed at subcostal or an intercostal approach in the mid-clavicular line, or in the right anterior axillary line.

The probe positioned below the diaphragm apposition zone with a rib cage from the middle of the pleural line to the peritoneal line. The measurement of diaphragm thickness was during inspiration and expiration.

RESULTS

Seven patients were included.

The average age was 49.5 ± 15.4 years. The average mechanical ventilation was 19.2 ± 10.8 days. The average weaning time was 6.0 ± 5.4 days.

Initial thickness mean was 0.41 ± 0.25cm and the final value was 0.53 ± 0.33cm, resulting in an increase of 22.5% and weaning success.

CONCLUSIONS

There was an increase in thickness of the diaphragm muscle and consequently successful in the weaning of mechanical ventilation.

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