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Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study

BACKGROUND: A correlation between unsuccessful noninvasive ventilation (NIV) and poor outcome has been suggested in de-novo Acute Respiratory Failure (ARF) patients. Consequently, it is of paramount importance to identify accurate predictors of NIV outcome. The aim of our preliminary study is to eva...

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Autores principales: Mercurio, Giovanna, D’Arrigo, Sonia, Moroni, Rossana, Grieco, Domenico Luca, Menga, Luca Salvatore, Romano, Anna, Annetta, Maria Giuseppina, Bocci, Maria Grazia, Eleuteri, Davide, Bello, Giuseppe, Montini, Luca, Pennisi, Mariano Alberto, Conti, Giorgio, Antonelli, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233594/
https://www.ncbi.nlm.nih.gov/pubmed/34174903
http://dx.doi.org/10.1186/s13054-021-03638-x
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author Mercurio, Giovanna
D’Arrigo, Sonia
Moroni, Rossana
Grieco, Domenico Luca
Menga, Luca Salvatore
Romano, Anna
Annetta, Maria Giuseppina
Bocci, Maria Grazia
Eleuteri, Davide
Bello, Giuseppe
Montini, Luca
Pennisi, Mariano Alberto
Conti, Giorgio
Antonelli, Massimo
author_facet Mercurio, Giovanna
D’Arrigo, Sonia
Moroni, Rossana
Grieco, Domenico Luca
Menga, Luca Salvatore
Romano, Anna
Annetta, Maria Giuseppina
Bocci, Maria Grazia
Eleuteri, Davide
Bello, Giuseppe
Montini, Luca
Pennisi, Mariano Alberto
Conti, Giorgio
Antonelli, Massimo
author_sort Mercurio, Giovanna
collection PubMed
description BACKGROUND: A correlation between unsuccessful noninvasive ventilation (NIV) and poor outcome has been suggested in de-novo Acute Respiratory Failure (ARF) patients. Consequently, it is of paramount importance to identify accurate predictors of NIV outcome. The aim of our preliminary study is to evaluate the Diaphragmatic Thickening Fraction (DTF) and the respiratory rate/DTF ratio as predictors of NIV outcome in de-novo ARF patients. METHODS: Over 36 months, we studied patients admitted to the emergency department with a diagnosis of de-novo ARF and requiring NIV treatment. DTF and respiratory rate/DTF ratio were measured by 2 trained operators at baseline, at 1, 4, 12, 24, 48, 72 and 96 h of NIV treatment and/or until NIV discontinuation or intubation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the ability of DTF and respiratory rate/DTF ratio to distinguish between patients who were successfully weaned and those who failed. RESULTS: Eighteen patients were included. We found overall good repeatability of DTF assessment, with Intra-class Correlation Coefficient (ICC) of 0.82 (95% confidence interval 0.72–0.88). The cut-off values of DTF for prediction of NIV failure were < 36.3% and < 37.1% for the operator 1 and 2 (p < 0.0001), respectively. The cut-off value of respiratory rate/DTF ratio for prediction of NIV failure was > 0.6 for both operators (p < 0.0001). CONCLUSION: DTF and respiratory rate/DTF ratio may both represent valid, feasible and noninvasive tools to predict NIV outcome in patients with de-novo ARF. Trial registration ClinicalTrials.gov Identifier: NCT02976233, registered 26 November 2016.
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spelling pubmed-82335942021-06-28 Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study Mercurio, Giovanna D’Arrigo, Sonia Moroni, Rossana Grieco, Domenico Luca Menga, Luca Salvatore Romano, Anna Annetta, Maria Giuseppina Bocci, Maria Grazia Eleuteri, Davide Bello, Giuseppe Montini, Luca Pennisi, Mariano Alberto Conti, Giorgio Antonelli, Massimo Crit Care Research BACKGROUND: A correlation between unsuccessful noninvasive ventilation (NIV) and poor outcome has been suggested in de-novo Acute Respiratory Failure (ARF) patients. Consequently, it is of paramount importance to identify accurate predictors of NIV outcome. The aim of our preliminary study is to evaluate the Diaphragmatic Thickening Fraction (DTF) and the respiratory rate/DTF ratio as predictors of NIV outcome in de-novo ARF patients. METHODS: Over 36 months, we studied patients admitted to the emergency department with a diagnosis of de-novo ARF and requiring NIV treatment. DTF and respiratory rate/DTF ratio were measured by 2 trained operators at baseline, at 1, 4, 12, 24, 48, 72 and 96 h of NIV treatment and/or until NIV discontinuation or intubation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the ability of DTF and respiratory rate/DTF ratio to distinguish between patients who were successfully weaned and those who failed. RESULTS: Eighteen patients were included. We found overall good repeatability of DTF assessment, with Intra-class Correlation Coefficient (ICC) of 0.82 (95% confidence interval 0.72–0.88). The cut-off values of DTF for prediction of NIV failure were < 36.3% and < 37.1% for the operator 1 and 2 (p < 0.0001), respectively. The cut-off value of respiratory rate/DTF ratio for prediction of NIV failure was > 0.6 for both operators (p < 0.0001). CONCLUSION: DTF and respiratory rate/DTF ratio may both represent valid, feasible and noninvasive tools to predict NIV outcome in patients with de-novo ARF. Trial registration ClinicalTrials.gov Identifier: NCT02976233, registered 26 November 2016. BioMed Central 2021-06-26 /pmc/articles/PMC8233594/ /pubmed/34174903 http://dx.doi.org/10.1186/s13054-021-03638-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Mercurio, Giovanna
D’Arrigo, Sonia
Moroni, Rossana
Grieco, Domenico Luca
Menga, Luca Salvatore
Romano, Anna
Annetta, Maria Giuseppina
Bocci, Maria Grazia
Eleuteri, Davide
Bello, Giuseppe
Montini, Luca
Pennisi, Mariano Alberto
Conti, Giorgio
Antonelli, Massimo
Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study
title Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study
title_full Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study
title_fullStr Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study
title_full_unstemmed Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study
title_short Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study
title_sort diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233594/
https://www.ncbi.nlm.nih.gov/pubmed/34174903
http://dx.doi.org/10.1186/s13054-021-03638-x
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