DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY, LVIV, UKRAINE.
Wiad Lek. 2023;76(2):257-263. doi: 10.36740/WLek202302103.
The aim: To find out whether diaphragm dysfunction might lead to unsuccessful weaning from MV.
Materials and methods: We provided prospective observational cohort study and included 105 patients and divided them in the study and the control groups. To consider diaphragm function, we check amplitude of its movement and diaphragm thickening fraction (Dtf). The primary outcome was the incidence of successful weaning from MV. The secondary outcomes were changes in diaphragm function parameters.
Results: In the current study, there were found that the incidence of successful weaning from MV was 100% for the day 1 in the control group, while in study group the incidence was significantly lower. Successfully weaned from MV in the study group among children 1 month - 1 year old on day 14 were 20 out 28 patients (71%), in children 1 - 3 years old - 9 out 11 patients (82%), in children 3 - 5 years old - 15 out 15 (100%). However, on day 1 - no one from the study group was weaned (0%), on day 7 - 5 out 28 patients 1 month - 1 year old (18%), 6 out 11 patients (55%) 1 - 3 years old, and 8 out 15 patients (53%) 3 - 5 years old (p<0.05).
Conclusions: Diaphragm dysfunction might alter weaning from MV.
探讨膈肌功能障碍是否会导致机械通气脱机失败。
我们进行了一项前瞻性观察性队列研究，纳入了 105 名患者，并将其分为研究组和对照组。为了评估膈肌功能，我们检查了其运动幅度和膈肌增厚分数（Dtf）。主要结局是机械通气脱机的成功率。次要结局是膈肌功能参数的变化。
在本研究中，对照组第 1 天机械通气脱机成功率为 100%，而研究组的成功率明显较低。在研究组中，1 个月至 1 岁的儿童第 14 天成功脱机的有 28 例中的 20 例（71%），1 至 3 岁的儿童有 11 例中的 9 例（82%），3 至 5 岁的儿童有 15 例中的 15 例（100%）。然而，第 1 天研究组无一人脱机（0%），第 7 天 1 个月至 1 岁的儿童有 28 例中的 5 例（18%），1 至 3 岁的儿童有 11 例中的 6 例（55%），3 至 5 岁的儿童有 15 例中的 8 例（53%）（p<0.05）。
膈肌功能障碍可能会改变机械通气的脱机过程。
