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August 20, 2026European Journal of PediatricsOpen Access

Diaphragm ultrasound parameters and rapid shallow breathing index for predicting weaning failure in mechanically ventilated infants: a prospective observational PICU study

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Authors

MAMarwa Ibrahem AbdelrazicRMReham Mohamed MokhtarAAAhmed Hussein Ahmed

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Overview

Prospective observational study finds diaphragm ultrasound and rapid shallow breathing index predict weaning failure in ventilated infants, indicating potential value for extubation timing.

Key Points

  • To evaluate whether diaphragm ultrasound parameters and the rapid shallow breathing index can predict mechanical ventilation weaning failure in infants in the pediatric intensive care unit.
  • Prospective observational study of 40 mechanically ventilated infants (aged 28 days to 12 months) ready for weaning assessment at Minia University Children and Maternity Hospital between January 2024 and January 2025.
  • Assessed diaphragmatic thickness at inspiration and expiration, diaphragm thickening fraction, inferior vena cava diameter, contractility, and rapid shallow breathing index (RSBI) during spontaneous breathing trials.
  • Weaning failure occurred in 6 infants (15.0%) and success in 34 (85.0%), with failure cases showing significantly lower inspiratory thickness [1.65 (1.61–1.66) vs. 1.83 (1.79–1.92) mm, P < 0.001] and lower thickening fraction [12.0 (11.3–13.5) vs. 26.0 (23.0–28.0)%, P < 0.001].
  • RSBI was significantly higher in infants who failed weaning compared to those successfully weaned [9.0 (9.0–9.8) vs. 7.0 (6.0–7.0), P < 0.001].
  • Cross-validated sensitivity and specificity were 100.0% and 100.0% for RSBI, 83.3% and 100.0% for thickening fraction, and 83.3% and 97.1% for inspiratory thickness.

Cite This Study

Abdelrazic et al. (2026) studied this question.

synapsesocial.com/papers/6a86b5b08a91293e6a1cd183https://doi.org/10.1007/s00431-026-07319-1
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