Prognostic significance of RSBI based on diaphragmatic ultrasound in the successful deactivation of non-invasive ventilation

doi:10.3877/cma.j.issn.1674-6902.2024.03.022

Abstract

Li Zhou, Xuan Liu, Lu Jing. Prognostic significance of RSBI based on diaphragmatic ultrasound in the successful deactivation of non-invasive ventilation[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(03): 450-453.

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References 26

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临床资料	观察组(n＝49)	对照组(n＝24)	χ²/t值	P值
BMI值(kg/m²)	22.06±1.86	21.92±1.94	0.338	0.737
APACHEⅡ评分(分)	13.81±2.01	14.11±1.94	0.706	0.483
PaCO₂(mmHg)	40.14±2.65	39.76±1.99	0.786	0.434
PaO₂/FiO₂(mmHg)	253.17±16.85	259.74±20.34	1.577	0.121
机械通气时间(d)	4.06±0.71	4.98±1.09	4.337	0.000
SBP(mmHg)	134.68±21.67	139.86±23.43	1.047	0.300
DBP(mmHg)	83.06±11.27	82.46±12.62	0.227	0.821
病因
AECOPD	11(22.45)	7(29.17)	0.391	0.532
心力衰竭	5(10.20)	3(9.37)	0.768	0.768
肺炎	13(26.53)	5(20.83)	0.281	0.596
ARDS	7(14.29)	5(20.83)	0.503	0.478
其他	12(24.49)	7(29.17)	0.183	0.669
肺部感染			0.483	0.786
双侧	28(57.14)	13(54.17)
右侧	15(30.61)	9(37.50)
左侧	6(12.24)	2(8.33)
胸腔积液
左侧	13(26.53)	4(16.67)	0.877	0.349
右侧	27(55.10)	11(45.83)	0.555	0.456

临床资料	观察组(n＝49)	对照组(n＝24)	χ²/t值	P值
BMI值(kg/m²)	22.06±1.86	21.92±1.94	0.338	0.737
APACHEⅡ评分(分)	13.81±2.01	14.11±1.94	0.706	0.483
PaCO₂(mmHg)	40.14±2.65	39.76±1.99	0.786	0.434
PaO₂/FiO₂(mmHg)	253.17±16.85	259.74±20.34	1.577	0.121
机械通气时间(d)	4.06±0.71	4.98±1.09	4.337	0.000
SBP(mmHg)	134.68±21.67	139.86±23.43	1.047	0.300
DBP(mmHg)	83.06±11.27	82.46±12.62	0.227	0.821
病因
AECOPD	11(22.45)	7(29.17)	0.391	0.532
心力衰竭	5(10.20)	3(9.37)	0.768	0.768
肺炎	13(26.53)	5(20.83)	0.281	0.596
ARDS	7(14.29)	5(20.83)	0.503	0.478
其他	12(24.49)	7(29.17)	0.183	0.669
肺部感染			0.483	0.786
双侧	28(57.14)	13(54.17)
右侧	15(30.61)	9(37.50)
左侧	6(12.24)	2(8.33)
胸腔积液
左侧	13(26.53)	4(16.67)	0.877	0.349
右侧	27(55.10)	11(45.83)	0.555	0.456

相关参数	观察组(n＝49)	对照组(n＝24)	χ²/t值	P值
HR(次/min)	80.49±8.62	81.67±9.18	0.606	0.547
RR(次/min)	16.64±4.06	17.14±3.78	0.596	0.553
平均动脉压(mmHg)	78.96±5.12	80.34±5.40	1.201	0.235
RSBI(次·min^－1·L^－1)	60.03±12.43	76.66±20.84	4.159	0.000
膈肌超声参数
膈肌收缩速度(cm/s)	1.62±0.45	2.09±0.68	3.541	0.001
DE-RSBI	1.38±0.34	2.11±0.42	8.533	0.000
DTF-RSBI	69.25±10.38	82.16±12.07	5.170	0.000

相关参数	观察组(n＝49)	对照组(n＝24)	χ²/t值	P值
HR(次/min)	80.49±8.62	81.67±9.18	0.606	0.547
RR(次/min)	16.64±4.06	17.14±3.78	0.596	0.553
平均动脉压(mmHg)	78.96±5.12	80.34±5.40	1.201	0.235
RSBI(次·min^－1·L^－1)	60.03±12.43	76.66±20.84	4.159	0.000
膈肌超声参数
膈肌收缩速度(cm/s)	1.62±0.45	2.09±0.68	3.541	0.001
DE-RSBI	1.38±0.34	2.11±0.42	8.533	0.000
DTF-RSBI	69.25±10.38	82.16±12.07	5.170	0.000

变　量	β	标准误	Wald	P值	OR	95%CI
变　量	β	标准误	Wald	P值	OR	下限	上限
机械通气时间	0.267	0.409	0.427	0.513	1.307	0.586	2.914
RSBI	－0.057	0.028	4.227	0.040	0.945	0.895	0.997
膈肌收缩速度	－0.553	0.869	0.405	0.525	0.575	0.105	3.161
DE-RSBI	－0.160	0.054	8.732	0.003	0.852	0.767	0.948
DTF-RSBI	－0.606	0.169	12.827	0.000	0.545	0.391	0.760
常数	27.003	6.787	15.830

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相关指标	AUC	敏感性(%)	特异性(%)	95% CI	准确率(%)	Youden指数
RSBI	0.743	80.62	72.50	0.643～0.827	79.17	0.531
DE-RSBI	0.799	90.62	72.50	0.704～0.874	78.12	0.531
DTF-RSBI	0.911	87.50	84.37	0.835～0.959	87.50	0.719
联合预测	0.962	92.19	87.50	0.902～0.990	90.62	0.797

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