Diaphragm ultrasound combined with D-RSBI predicts weaning outcomes in neurocritical patients on mechanical ventilation.

This retrospective analysis evaluated 128 patients with severe neurological conditions receiving mechanical ventilation in the Department of Neurosurgery at Chongqing Emergency Medical Center. The study compared diaphragm ultrasound parameters, specifically Diaphragmatic Excursion (DE) and Diaphragmatic Thickening Fraction (DTF), combined with Diaphragmatic Rapid Shallow Breathing Index (D-RSBI) against traditional RSBI alone. The primary outcome assessed weaning success versus failure, while secondary outcomes included mechanical ventilation duration, respiratory rate, and heart rate.

Analysis revealed that traditional RSBI and D-RSBI values were statistically significantly lower in the successful weaning group compared to the failed weaning group. Conversely, Diaphragmatic Excursion and Diaphragmatic Thickening Fraction were statistically significantly higher in patients who successfully weaned compared to those who failed. These findings suggest that integrating ultrasound metrics with D-RSBI may enhance the prediction of weaning trajectories in this specific population.

No adverse events, serious adverse events, discontinuations, or tolerability data were reported in this study. A key limitation identified is the need for external validation to confirm these findings in other settings. Consequently, while the combination of diaphragm ultrasound and D-RSBI appears effective for predicting weaning outcomes in neurocritical patients, clinicians should await further validation before altering standard weaning protocols.