Table 1.
Studies included in the systematic review and meta-analysis
| Autors | Country | Year | Design | n | Age | Reason for mechanical ventilation | Prevalence of success | Patient position during US | Cut-off success weaning | MV duration at inclusion (hours) | Evaluated Diaphragm | Mode/ sound | Tipe SBT | Weaning success definition |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jung B, et al | France | 2016 | Prospective cohort | 40 | 58 (51–67) | ARF 65% | 50% | 20 a 30° | DTF ≥ 30% | > 48 h | Left and right | Not described | PS /T-tube | No reintubation or tracheostomy > 48 h after extubation |
| Blumhof et al | USA | 2016 | Prospective cohort | 56 | 62 ± 17 | ARF 73% | 86.5% | Semi-recumbent 20–40° | DTF > 20% | > 24 h | Right | Mode B 7,5–10 MHz | PS | Spontaneous respiration > 48 h after extubation |
| Mariani Lf et al | France | 2016 | Prospective cohort | 34 | 646 ± 14.8 | Multicausal COPD 26% | 100% | Semi-recumbent 30° | DE left _ > 11 mm ED right ≥ 10 mm | MV > 7 days | Left and right | 3–5 MHz/ Mode M | T-tube | Spontaneous respiration > 72 h after extubation |
| Flevari et al | Greece | 2016 | Prospective cohort | 27 | 65 | Multicausal | Not described | Supine | DE right > 10 mm > 7 mm left | Not described | Left and right | 5 MHz Mode B/ M | T-tube | SBT success, no reintubation or NIV > 48 h after extubation |
| Hayat et al | Pakistan | 2017 | Prospective observational | 100 | 40.5 | Respiratory disease 73% | 76% | Supine | DE > 1.2 cm | Not described | Left and right | 3.5 MHz/not described | Not described | Success in the next 48 h without the need for NIV or reintubation |
| Huang et al | China | 2017 | Prospective observational | 40 | 84.25 ± 7.07 | Multicausal COPD 52.5% | 30% | Semi-incorporated | DE > 10 mm | > 48 h | Left and right | 1.5 MHZ/ Mode M | T-tube | Unassisted respiration > 48 h |
| Farghaly et al | Egypt | 2017 | Prospective observational | 54 | Success group 65 (55–67.8) Failure group 62.5 (55–70.7) | Respiratory disease unspecified | 74% | Semi-recumbent | DE ≥ 10.5 mm, Tdi ≥ 21 mm end inspiration, ≥ 10.5 mm Tdi end expiration, DTF ≥ 34.2% | Not described | Right | 3.5 MHZ/Mode B | PS | Spontaneous respiration > 48 h after extubation |
| Osman et al | Egypt | 2017 | Prospective observational | 68 | 56 (45–65) | Major surgery | 73.5% | Semi-recumbent | DE > 10 mm DTF > 28% | Not described | Left and right | 3.5 y 9–11 MHZ Mode M | T-tube | Spontaneous respiration > 48 h after extubation |
| Dres et al | France | 2018 | Prospective cohort | 76 | 58 (48–68) | Multicausal ARF 40% | 43.5% | Semi-incorporated | Contraction pressure > 7.2 cmH2O, DTF 25.8% | > 24 h | Left and right | 4–12/Mode M | PS | Spontaneous respiration > 48 h after extubation |
| Yoo et al | Corea | 2018 | Prospective observational | 60 | 69.5 (57.5–76) | Multicausal COPD 23.3% | 78.3% | Not described | DE ≥ 1 cm and Δtdi ≥ 20% | > 48 h | Right | 2–5; 6–13 /Mode M/ B | PS /T-tube | Success > 48 h without requiring NIV |
| Pirompanich et al | Thailand | 2018 | Prospective cohort | 34 | 66.5 (± 13.5) | Multicausal COPD/ asthma 5.9% | 73.5% | Semi-incorporated | DTF right ≥ 26% | > 24 h | Left and right | Lineal 10 MHZ/mode B/ M | T-tube | Spontaneous respiration > 48 h after extubation |
| Palkar et al | Norway | 2018 | Prospective cohort | 73 | 71 | Multicausal COPD/ asthma 21.9% | 72.6% | Semi-recumbent 20–40° | Excursion-time index > 3.8% | > 24 h | Right | 3.5 MHZ/Mode M | PS | Spontaneous respiration > 48 h after extubation |
| Tenza Lozano | Spain | 2018 | Prospective cohort | 69 | 66 (53–78) | Multicausal respiratory disease 34.8% | 63.7% | Semi-recumbent 20 a 40° | DTF > 24% | > 24 h | Right | Lineal 7 a 10 MHZ/ mode B/ M | PS/T-tube | Spontaneous respiration > 48 h after extubation |
| Theerawit et al | Thailand | 2018 | Prospective cross-sectional | 62 | 66.48 (± 16,7) | Multicausal respiratory disease 19.3% | 82.2% | Supine | DE > 12.85 mm | > 48 h | Left and right | 1–5 MHZ/Mode B/ M | PS/T-tube | Spontaneous respiration > 48 h after extubation |
| Mowafy et al | Egypt | 2019 | Prospective randomized clinical trial | 106 | Group I 35.83(± 9.46) Group II 35.77(± 9.56) | Polytrauma | 68.9% | Semi-recumbent 30 a 40° | DRSBI > 1.6 | > 48 h | Right | 2–5 MHZ Mode B/ M | PS | Spontaneous respiration > 48 h after extubation |
| Vivier et al | France | 2019 | Prospective multicenter | 191 | 68 (±) | Respiratory disease 40% | 83% | Not described | DE > 10 mm and DTF > 30% | vm > 7 days | Left and right | Lineal 4 y 10 MHZ Mode M | T-tube | Reintubation failure or death within 7 days after extubation |
| Varon et al | Colombia | 2019 | Prospective observational | 84 | 58(35–51) | HRF 25% | 79.8% | Semi-incorporated 45° | DC velocity > 2.9 cm/s in the SG; > 2.02 cm/s in the FG | > 48 h | Right | 1–5 y 6–13 MHZ Mode M | PS/T-tube | Spontaneous respiration > 48 h after extubation |
| Soliman et al | Egypt | 2019 | Prospective observational | 100 | 57.1 (± 14.5) | ARF unspecified 62% | 80% | Not described | DTF > 29.5% | > 24 h | Left and right | Lineal 10 MHZ/Mode B/ M | PS | Success of SBT, no reintubation or death > 48 h |
| Eltrabili et al | Egypt | 2019 | Prospective observational | 30 | Success 52.7 (± 13.4) Failure 51.4 (± 13.1) | Abdominal sepsis | 56.6% | Semi-recumbent | DTF > 30.7% and DE > 10.4 mm | > 48 h | Left and right | 7.5-10MHZ Mode B/ M | PS | Successful spontaneous breathing and no use of NIV > 48 h after extubation |
| Abdelwahed et al | Egypt | 2019 | Prospective observational | 65 | Success 43.49 ± 12.88 Failure 40.85 ± 14.28 | Multicausal respiratory disease 16.98% | 78.4% | Semi-incorporated 30–45° | DTF > 30% | Not described | Left and right | 10–15 MHZ Mode B/ M | T-tube | Spontaneous respiration > 48 h after extubation |
| Elshazly et al | Egypt | 2020 | Prospective observational | 62 | Success 65 (55–70) Failure 60.5 (52.2–70) | Respiratory disease COPD 24% | 54.8% | Semi-incorporated | DE > 1.25 cm and DTF > 21.5% | > 24 h | Left and right | 3.5 y 7–12 MHZ Mode B/ M | Not described | Spontaneous respiration > 48 h after extubation |
| Fossat et al | France | 2021 | Single-center prospective observational | 100 | 66(± 15) | Multicausal COPD 14% | 91% | Not described | RSBI and RSBI/DE had a value of 0.50 either at minute 5 and 0.55 at minute 25 of SBT to predict success | > 24 h | Right | 5MHZ/Mode M | PS | Spontaneous respiration > 72 h after extubation |
| Shigang Li et al | China | 2021 | Prospective observational | 101 | > 65 | Multicausal COPD 10% | 68.3% | Not described | DTF ≥ 30%, DE ≥ 1.3 cm | > 24 h | Left and right | 2–5, 5–13 MHZ/Mode B/ M | T-tube | No reintubation, NIV or tracheostomy > 48 h after extubation |
| Funda Gok et al | Turkey | 2021 | Prospective observational | 62 | 57.6 (± 14.1) | Polytrauma 77% | 64% | Not described | DTF > 27.5% DE > 1.3 cm | > 48 h | Right | 2–4 MHZ/Mode M | T-tube | SBT success, no reintubation, no NIV > 48 h post-extubation |
| Alam M et al | Bangladesh | 2022 | Prospective observational | 31 | 42 (± 16) | Multicausal COPD 32% | 58% | Semi-recumbent 20–40° | DE ≥ 11.43 mm DTF 19.77% | > 11 days | Right | 2–4-13 MHZ/Mode B/ M | T-tube | Spontaneous respiration > 48 h after extubation |
| Mawla et al | Egypt | 2022 | Prospective cohort | 90 | 18–97 | Respiratory disease COPD 36.7% | 56.6% | Semi-recumbent | DE 1.3 cm DTF 13.5%, contraction velocity > 0.95 cm/s and relaxation rate 0.7 cm/sg | > 48 h | Right | Mode B 9 MHZ/M 4MHZ | PS | Spontaneous respiration > 48 h after extubation |
From: Effectiveness of diaphragmatic ultrasound as a predictor of successful weaning from mechanical ventilation: a systematic review and meta-analysis
DRSBI rapid and shallow diaphragmatic breathing rate, DE diaphragmatic excursion, DTF diaphragm thickening fraction, VM mechanical ventilation, PS pressure support, SBT spontaneous breathing trial, NIV noninvasive ventilation, US ultrasound, SG success group, FG failure group, MHZ megahertz, TDi diaphragmatic thickness, DC Diaphragmatic contraction, ARF Acute respiratory failure, COPD chronic obstructive pulmonary disease, HRF hypoxemic respiratory failure