Ultrasonographic evaluation of liver/spleen movements and extubation outcome.
BACKGROUND
The diaphragm plays a pivotal role in weaning and successful extubation. We hypothesized that ultrasonographic evaluation of the movements of the diaphragm by measuring liver/spleen displacement during spontaneous breathing trials is a good predictor for extubation outcome.


METHODS
The studied subjects were intubated patients receiving mechanical ventilation who were scheduled to be extubated. The displacement of liver/spleen was measured by ultrasonography before extubation. The patients were classified into a success group (SG) or failure group according to the extubation outcome. The baseline data and organ displacements in these two groups were analyzed. The sensitivity and specificity for the mean organ displacements and weaning parameters to predict successful extubation were calculated.


RESULTS
We included 55 patients, 32 of whom (58%) were in the SG. The baseline data are similar for these two groups, but the mean values of liver and spleen displacements were higher in the SG. Using a cutoff value of 1.1 cm, the sensitivity and specificity to predict successful extubation were 84.4% and 82.6%, respectively, better than traditional weaning parameters in this study.


CONCLUSIONS
The displacement of the liver/spleen, measured by ultrasonography, is a good predictor for extubation outcome.
Jiang
Jung-Rern
JR
Department of Internal Medicine, Yun Lin Hospital, Executive Yuan, Taiwan.
Tsai
Tzu-Hsiu
TH
Jerng
Jih-Shuin
JS
Yu
Chong-Jen
CJ
Wu
Huey-Dong
HD
Yang
Pan-Chyr
PC
D000328:Adult; D000368:Aged; D003964:Diaphragm / Q000502:physiology; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012121:Respiration, Artificial; D013154:Spleen / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D015300:Ventilator Weaning / Q000379:methods*