Sonographic assessment of the diaphragm in COVID 19 and non-COVID ICU patients

Abstract

Abstract Background Sonographic evaluation of the diaphragm has gained popularity in the ICU due to the necessity of assessing diaphragmatic function in a variety of clinical situations. The sonographic examination of diaphragmatic dynamics in ICU patients by measuring diaphragmatic thickness and excursion in connection to various modalities of mechanical ventilation (MV) and patient outcomes was the objective of this study. Methods This prospective observational study was carried out on 50 patients in respiratory ICU in Kafr Elsheikh and Benha University Hospitals. Patients were classified into 2 equal groups: COVID-19 group and non-COVID group. All patients underwent ultrasound assessment included the diaphragm thickness fraction and excursion in ICU patients on admission and on weaning. Results Successful weaning (SW) was higher in group I compared to group II. In group I (COVID), diaphragm excursion, thickness at end inspiration and at end expiration in NIV at weaning were significantly higher in patients with SW but thickness at end expiration on admission was significantly lower. In group II (non-COVID) MV patients, excursion at weaning was significantly higher in patients with SW, also were thickness at end inspiration and end expiration on admission, thickness at end inspiration and end expiration at weaning in NIV patients but thickness at end inspiration in MV on admission was significantly lower. Conclusion Weaning success and mortality were significantly predicted by excursion in NIV at weaning, thickness at end inspiration in MV at weaning, thickness at end inspiration in NIV at weaning, and thickness at end expiration in MV at weaning.