Aim: To evaluateroleofdiaphragmaticthickeningandexcursion,assessedultrasonographically,inpre-
dicting extubationoutcome.
Methods: Fifty-four patientswhosuccessfullypassedspontaneousbreathingtrial(SBT)wereenrolled.
They wereassessedbyultrasoundduringSBTevaluatingdiaphragmaticexcursion,diaphragmatic
thickness (Tdi)atendinspiration,atendexpirationanddiaphragmaticthicknessfraction(DTF%).Simul-
taneously traditionalweaningparameterswererecorded.Patientswerefollowedupfor48hafter
extubation.
Results: Out of54includedpatients,14(25.9%)failedextubation.Diaphragmaticexcursion,Tdiatend
inspiration, atendexpirationandDTF%weresignificantlyhigherinthesuccessfulgroupcomparedto
those whofailedextubation(p < 0.05).Cutoffvaluesofdiaphragmaticmeasuresassociatedwithsuccess-
ful extubationwere≥10.5mmfordiaphragmaticexcursion,≥21mmforTdiatendinspiration,≥10.5mm
for Tdiatendexpiration, ≥34.2% forDTF%giving87.5%,77.5%,80%and90%sensitivityrespectivelyand
71.5%, 86.6%,50%and64.3%specificityrespectively.Combiningdiaphragmaticexcursion ≥10.5mmand
Tdi atendinspiration ≥21mmdecreasedsensitivityto64.9%butincreasedspecificityto100%.Rapid
shallow breathingindex(RSBI)<105had90%sensitivitybut18.7%specificity.
Conclusion: Ultrasound evaluationofdiaphragmaticexcursionandthicknessatendinspirationcouldbe
a goodpredictorofextubationoutcomeinpatientswhopassedSBT.Itisrecommendedtoconsiderthe
use oftheseparameterswithRSBIconsequentlytoimproveextubationoutcome.