TO ASSESS THE DIAPHRAGMATIC AND LUNG USG TO PREDICT THE OUTCOME OF WEANING PROCESS.

Aim: The aim of the present study was to assess the diaphragmatic and lung USG to predict the outcome of weaning process. Methods: The proposed study has been conducted on critically ill post-surgical patients on mechanical ventilation aged between 18-65 years, in intensive care unit of Department of Anaesthesiology and CCM, Nehru hospital, B.R.D. Medical College, Gorakhpur, Uttar Pradesh from December 2020 to November 2021. 110 patients were included in the study. Results: There was significant difference observed in failure rate of extubation among different age groups as age increases the rate of failure also increases significantly (p<0.0001). There was no significant difference observed in success rate of extubation across gender (success rate: male vs female: 88.2% vs 86.8%, p=0.839). Failure rate of extubation was significantly higher in those patients who had any comorbidities as compared to those who had no comorbidities. Mean LUS Score on CPAP was significantly lower in success group as compared to failure group. Mean LUS Score after extubation was significantly lower in success group as compared to failure group. Mean DTF on CPAP was significantly higher in success group as compared to failure group. Mean DTF on T piece was significantly higher in success group as compared to failure group. Mean DTF after Extubation was significantly higher in success group as compared to failure group. Likewise, Mean E on CPAP was significantly higher in success group as compared to failure group. Mean E on T piece was significantly higher in success group as compared to failure group. Mean E after extubation was significantly higher in success group as compared to failure group. Conclusion: The weaning outcome can be predicted by LUS score, diaphragmatic thickness fraction (DTF), diaphragmatic excursion (E) in mechanically ventilated patients. A value of LUS score on T-piece ≤10 predicts the successful weaning final outcome. A value of DTF on T-piece ≥31% predicts the successful weaning final outcome. Similarly, a value of E on Tpiece ≥18mm also predicts a successful weaning outcome. Increased rate of weaning failure observed in older age group, patients with co-morbidities and high SOFA score. Also prolonged duration of mechanical ventilation caused failure in weaning. [ABSTRACT FROM AUTHOR]