Why the study?
Tissue Doppler imaging was applied to assess diaphragmatic muscle motion velocity during contraction and relaxation.
Does diaphragmatic Tissue Doppler Imaging differentiate ICU patients who fail a weaning trial from those who succeed?
Observational (n=136)
No
Does diaphragmatic Tissue Doppler Imaging differentiate ICU patients who fail a weaning trial from those who succeed?
Diaphragmatic tissue Doppler imaging is a reproducible technique that can differentiate ICU patients who fail a weaning trial from those who succeed.
This is the authors' abstract. We don't add key points for this paper.
Rationale Tissue Doppler imaging (TDI) is an echocardiographic method that measures the velocity of moving tissue. Objectives We applied this technique to the diaphragm to assess the velocity of diaphragmatic muscle motion during contraction and relaxation. Methods In 20 healthy volunteers, diaphragmatic TDI was performed to assess the pattern of diaphragmatic motion velocity, measure its normal values, and determine the intra- and interobserver variability of measurements. In 116 consecutive ICU patients, diaphragmatic excursion, thickening, and TDI parameters of peak contraction velocity, peak relaxation velocity, velocity–time integral, and TDI-derived maximal relaxation rate were assessed during weaning. In a subgroup of 18 patients, transdiaphragmatic pressure (Pdi)-derived parameters (peak Pdi, pressure–time product, and diaphragmatic maximal relaxation rate) were recorded simultaneously with TDI. Measurements and Main Results In terms of reproducibility, the intercorrelation coefficients were >0.89 for all TDI parameters (P < 0.001). Healthy volunteers and weaning success patients exhibited lower values for all TDI parameters compared with weaning failure patients, except for velocity–time integral, as follows: peak contraction velocity, 1.35 ± 0.34 versus 1.50 ± 0.59 versus 2.66 ± 2.14 cm/s (P < 0.001); peak relaxation velocity, 1.19 ± 0.39 versus 1.53 ± 0.73 versus 3.36 ± 2.40 cm/s (P < 0.001); and TDI-maximal relaxation rate, 3.64 ± 2.02 versus 10.25 ± 5.88 versus 29.47 ± 23.95 cm/s2 (P < 0.001), respectively. Peak contraction velocity was strongly correlated with peak transdiaphragmatic pressure and pressure–time product, whereas Pdi-maximal relaxation rate was significantly correlated with TDI-maximal relaxation rate. Conclusions Diaphragmatic tissue Doppler allows real-time assessment of the diaphragmatic tissue motion velocity. Diaphragmatic TDI-derived parameters differentiate patients who fail a weaning trial from those who succeed and correlate well with Pdi-derived parameters.
Answers are grounded in this paper and cite their sources.
Diaphragmatic tissue Doppler velocities were associated with weaning failure; hypothesis-generating for differentiation of trial outcomes before clinical adoption.
No takes yet. Share an insight, caveat, or question.
Soilemezi et al. (2020) conducted an observational in Respiratory failure requiring mechanical ventilation (n=136). Weaning failure vs. Weaning success was evaluated on Peak contraction velocity (PCV) during weaning trial (p=<0.001).
Synapse has enriched 10 related papers. Consider them for comparative context: