الفهرس 
Weaning from Mechanical VentilationOnly 14 pages are availabe for public view
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Abstract
As difficult weaning is frequent intensive care unit (ICU) problem, parasternal intercostal muscle ultrasound could help in the assessment of the respiratory capacity/load balance and respiratory muscle function monitoring is therefore considered a weaning process tool.
This study aimed to evaluate the role of ultrasound assessment of parasternal intercostal muscles thickness during weaning from mechanical ventilation. The primary outcome was to assess the change of the parasternal intercostal muscles thickness at end of expiration and end of inspiration to verify the thickness fraction of the parasternal intercostal muscle as a predictor of successful spontaneous breathing trials.
The secondary outcomes: Finding the correlation between the parasternal intercostal muscle thickening fraction and the presence or absence of diaphragmatic dysfunction. Finding the optimum cut-off value for the parasternal intercostal muscles thickening fraction with the best predicting accuracy of success or failure of the spontaneous breathing trials.
It was a prospective observational study that was carried out on 40 mechanically ventilated patients recruited from intensive care units of Menoufia university hospital from June 2020 to April 2021 after approval of medical ethical committee. Patients were recruited 6–24 h prior to the first weaning trial. Informed consent was obtained from the patients’ health-care proxy.
All patients were clinically assessed upon recruitment in the study. Body mass index (BMI) were recorded. APACHE II score and charlson comorbidity index (CCI) was assessed on ICU admission. Monitoring by Consciousness level (by Glascow coma score), electrocardiography (ECG), non invasive blood pressure monitoring, arterial blood gases (ABG), pulse oximetry, respiratory rate (RR), tidal volume (Vt). Parasternal intercostal muscle ultrasound was performed before the start of the spontaneous breathing trial while the patients were ventilated under pressure support ventilation with PEEP of ≤ 8 cm H2O and pressure support set to reach a tidal volume of 6 to 8ml/ kg of predicted ideal body weight. Diaphragm ultrasound was performed before the start of the spontaneous breathing trial to assess the presence or abscense of diaphragmatic dysfunction. Spontaneous Breathing Trial (SBT) was done after assessment of the parasterna