Cardiothoracic & vascular anesthesia
Diaphragm Dysfunction Predicts Weaning Outcome after Bilateral Lung Transplant
Authors' conclusion
Diaphragm dysfunction is common after bilateral-lung transplantation and associated with difficult weaning.
Study context
- Population
- Adult bilateral-lung transplant patients in the ICU at the first SBT (pressure-support 5 cm H2O, 0 PEEP)
- Participants
- 44 patients
- Exposure
- Difficult vs simple weaning
- Difficult weaningn = 18
- Outcome
- Diaphragm dysfunction (diaphragm thickening fraction <29%)
Main finding
As reported in the abstract
Difficult weaning
78%
14 of 18
- Diaphragm dysfunction, all subjects
- 14 (32%)
Observational data: associations, not effects.
Further findings
| Outcome | Diaphragm thickening fraction | Neuroventilatory efficiency |
|---|---|---|
| Prediction of difficult weaning (AUC) | ||
| AUC | 0.88 (95% CI, 0.73 to 0.99) | 0.85 (95% CI, 0.71 to 0.95) |
- Diaphragm thickening fraction (median [IQR]) · 5th minute of first SBT — Lower in difficult weaning · lower in difficult weaning
- 24 [20 to 29] vs. 39 [35 to 45]% · P < 0.001
- Neuroventilatory efficiency (median [IQR]) · 5th minute of first SBT — Lower in difficult weaning · lower in difficult weaning
- 34 [26 to 45] vs. 55 [43 to 62] ml/µV · P < 0.001
Duration of ventilation before first SBT
- Linear inverse correlation with both diaphragm thickening fraction and neuroventilatory efficiency
Original publication
Diaphragm Dysfunction Predicts Weaning Outcome after Bilateral Lung Transplant. Anesthesiology. Published 8 August 2023. doi:10.
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