Role of ventilator and ultrasound parameters in predicting extubation success

Abstract The gold standard method for an accurate and easy way to predict successful weaning has not been established. The study was aimed to determine the predictive values of airway occlusion pressure (P0.1), parasternal intercostal muscle, and diaphragm for successful extubation and their correla...

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Main Authors: R. Muralidharan, Amarja Ashok Havaldar
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-05540-w
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author R. Muralidharan
Amarja Ashok Havaldar
author_facet R. Muralidharan
Amarja Ashok Havaldar
author_sort R. Muralidharan
collection DOAJ
description Abstract The gold standard method for an accurate and easy way to predict successful weaning has not been established. The study was aimed to determine the predictive values of airway occlusion pressure (P0.1), parasternal intercostal muscle, and diaphragm for successful extubation and their correlation with ICU length of stay and duration of mechanical ventilation. We recruited patients who had been admitted to ICU and mechanically ventilated for at least 48 h. Patients who had successfully passed the spontaneous breathing trial (SBT) and planned for extubation were screened. P 0.1 parameter was obtained from the ventilator. We measured parasternal intercostal muscle thickness (PIMT), parasternal intercostal muscle thickening fraction (PIMTF), diaphragm thickness (DT) and diaphragm thickening fraction (DTF). Primary outcome was to determine the predictive values of P 0.1, PIMTF & DTF for successful extubation. Of the 126 enrolled patients, 101(80.1%) were successfully extubated and 25 (19.8%) had extubation failure. The predictive thresholds for successful extubation for P 0.1 was 1.8 cm of H2O (88% sensitivity and 81% specificity with area under receiver operating characteristic curve (AUC) of 0.907, for PIMTF was 12.5% (100% sensitivity and 98% specificity with AUC 0.999), and for DTF was 22.8% (84% sensitivity and 94% specificity with AUC 0.907). P0.1, PIMTF, and DTF are independently linked to extubation outcomes and a combination of these three variables could serve as a valuable tool for accurate prediction of successful extubation.
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spelling doaj-art-3f46a04ead834cf987f2d7e9f7b305b72025-08-20T04:01:26ZengNature PortfolioScientific Reports2045-23222025-07-011511810.1038/s41598-025-05540-wRole of ventilator and ultrasound parameters in predicting extubation successR. Muralidharan0Amarja Ashok Havaldar1Department of Critical Care Medicine, Baby Memorial HospitalDepartment of Critical Care, St. John’s Medical College, HospitalAbstract The gold standard method for an accurate and easy way to predict successful weaning has not been established. The study was aimed to determine the predictive values of airway occlusion pressure (P0.1), parasternal intercostal muscle, and diaphragm for successful extubation and their correlation with ICU length of stay and duration of mechanical ventilation. We recruited patients who had been admitted to ICU and mechanically ventilated for at least 48 h. Patients who had successfully passed the spontaneous breathing trial (SBT) and planned for extubation were screened. P 0.1 parameter was obtained from the ventilator. We measured parasternal intercostal muscle thickness (PIMT), parasternal intercostal muscle thickening fraction (PIMTF), diaphragm thickness (DT) and diaphragm thickening fraction (DTF). Primary outcome was to determine the predictive values of P 0.1, PIMTF & DTF for successful extubation. Of the 126 enrolled patients, 101(80.1%) were successfully extubated and 25 (19.8%) had extubation failure. The predictive thresholds for successful extubation for P 0.1 was 1.8 cm of H2O (88% sensitivity and 81% specificity with area under receiver operating characteristic curve (AUC) of 0.907, for PIMTF was 12.5% (100% sensitivity and 98% specificity with AUC 0.999), and for DTF was 22.8% (84% sensitivity and 94% specificity with AUC 0.907). P0.1, PIMTF, and DTF are independently linked to extubation outcomes and a combination of these three variables could serve as a valuable tool for accurate prediction of successful extubation.https://doi.org/10.1038/s41598-025-05540-wDiaphragmExtubationP 0.1Parasternal intercostal muscleSpontaneous breathing trialUltrasound
spellingShingle R. Muralidharan
Amarja Ashok Havaldar
Role of ventilator and ultrasound parameters in predicting extubation success
Scientific Reports
Diaphragm
Extubation
P 0.1
Parasternal intercostal muscle
Spontaneous breathing trial
Ultrasound
title Role of ventilator and ultrasound parameters in predicting extubation success
title_full Role of ventilator and ultrasound parameters in predicting extubation success
title_fullStr Role of ventilator and ultrasound parameters in predicting extubation success
title_full_unstemmed Role of ventilator and ultrasound parameters in predicting extubation success
title_short Role of ventilator and ultrasound parameters in predicting extubation success
title_sort role of ventilator and ultrasound parameters in predicting extubation success
topic Diaphragm
Extubation
P 0.1
Parasternal intercostal muscle
Spontaneous breathing trial
Ultrasound
url https://doi.org/10.1038/s41598-025-05540-w
work_keys_str_mv AT rmuralidharan roleofventilatorandultrasoundparametersinpredictingextubationsuccess
AT amarjaashokhavaldar roleofventilatorandultrasoundparametersinpredictingextubationsuccess