الفهرس 
Serial assessment of diaphragmatic and quadriceps muscles thickness by ultrasound and their impact on discontinuation of mechanical ventilation
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Abstract
Background: Diaphragmatic weakness is common in patients undergoing MV and is likely a contributing cause of weaning failure. Recent studies have suggested that the ventilator is a likely cause of the decreased diaphragm force generating capacity seen in mechanically ventilated patients. On the other hand, myopathy is a common complication of ICU stay and may delay weaning of mechanical ventilation. The study was focused on detecting the changes of both diaphragmatic and quadriceps muscles in different modes of mechanical ventilation by using ultrasound and to use diaphragm thickness and excursion as a predictor of weaning outcome. Patients and Methods: This study included 50 invasively mechanically ventilated patients. Diaphragmatic thickness (DT), diaphragmatic excursion (DE) and quadriceps muscle thickness were measured every 48 hours starting from first day of mechanical ventilation. Results: Patients on spontaneous modes of mechanical ventilation showed a higher values of DT, DE and DTF compared to patients on controlled modes. Also patients with successful extubation showed higher values of DTF and DE compared to patients with failed weaning. The changes in diaphragmatic functions had occurred as early as first days of mechanical ventilation. The receiver operator characteristic (ROC) curves showed cut-off points for successful weaning 0.33 and 19mm for DTF and DE respectively. Quadriceps muscle showed a daily decrease of thickness regardless the mode of ventilation and there was no correlation with either DTF or DE