{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:21:15Z","timestamp":1793830875948,"version":"4.6.1"},"reference-count":43,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Brazilian Council for Scientific and Technological Development"},{"name":"Rio de Janeiro State Research Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: This study analyzed weaning characteristics and assessed the association of clinical and ultrasonographic indices\u2014maximum inspiratory pressure (MIP), rapid shallow breathing index (RSBI), peak flow expiratory (PFE), diaphragm-thickening fraction (DTF), diaphragm thickness (DT), diaphragm excursion (DE), diaphragm-RSBI (D-RSBI), and lung ultrasound (LUS) patterns\u2014with weaning failure. Methods: This retrospective cohort study included critically ill COVID-19 patients aged 18 and older who had been on invasive mechanical ventilation for at least 48 h and undergoing weaning. Exclusion criteria included absence of ultrasound assessments, neuromuscular diseases, and chronic cardio-respiratory dysfunction. Results: Among 61 patients, 44.3% experienced weaning failure, 27.9% failed the spontaneous breathing trial (SBT), 16.4% were re-intubated within 48 h, and 28% required tracheostomy. Weaning failure was associated with prolonged ventilation (29 vs. 7 days, p &lt; 0.001), extended oxygen therapy, longer ICU stays, and higher ICU mortality. These patients had higher pressure support, lower oxygenation levels, a higher RSBI, and a lower MIP. While PEF, DTF, DE, and D-RSBI showed no significant differences, both right and left diaphragm thicknesses and the inspiratory thickness of the left diaphragm were reduced in failure cases. LUS scores were significantly higher before and after SBT in the failure group. Bivariate analysis identified RSBI [OR = 1.04 (95% CI = 1.01\u20131.07), p = 0.010], MIP [OR = 0.92 (95% CI = 0.86\u20130.99), p = 0.018], and LUS [OR = 1.15 (95% CI = 0.98\u20131.35), p = 0.025] as predictors of weaning failure; however, these associations were not confirmed in multivariate analysis. Conclusions: Ultrasound provides supplementary information during weaning, but no definitive association between ultrasound indices and weaning failure was confirmed in this study.<\/jats:p>","DOI":"10.3390\/diagnostics14202263","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T08:10:16Z","timestamp":1728634216000},"page":"2263","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Predictive Value of Diaphragm and Lung Ultrasonography for Weaning Failure in Critically Ill Patients with Acute Respiratory Failure Due to COVID-19 Pneumonia"],"prefix":"10.3390","volume":"14","author":[{"given":"Camila","family":"Fonseca","sequence":"first","affiliation":[{"name":"Unidad de Paciente Cr\u00edtico Adulto, Hospital Las Higueras, Talcahuano 4270918, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Novoa","sequence":"additional","affiliation":[{"name":"Unidad de Paciente Cr\u00edtico Adulto, Hospital Las Higueras, Talcahuano 4270918, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matias","family":"Aguayo","sequence":"additional","affiliation":[{"name":"Unidad de Paciente Cr\u00edtico Adulto, Hospital Las Higueras, Talcahuano 4270918, Chile"},{"name":"Escuela de Kinesiolog\u00eda, Universidad Nacional Andr\u00e9s Bello, Sede Concepci\u00f3n, Concepci\u00f3n 8370146, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8556-9713","authenticated-orcid":false,"given":"Ricardo","family":"Arriagada","sequence":"additional","affiliation":[{"name":"Unidad de Paciente Cr\u00edtico Adulto, Hospital Las Higueras, Talcahuano 4270918, Chile"},{"name":"Escuela de Kinesiolog\u00eda, Universidad San Sebasti\u00e1n, Sede Tres Pascualas, Concepci\u00f3n 7510602, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crist\u00f3bal","family":"Alvarado","sequence":"additional","affiliation":[{"name":"Unidad de Paciente Cr\u00edtico Adulto, Hospital Las Higueras, Talcahuano 4270918, Chile"},{"name":"Facultad de Medicina, Universidad Cat\u00f3lica de la Sant\u00edsima Concepci\u00f3n, Concepci\u00f3n 4030000, Chile"},{"name":"Unidad de Investigaci\u00f3n, Hospital Las Higueras, Talcahuano 4270918, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar","family":"Pedreros","sequence":"additional","affiliation":[{"name":"Unidad de Paciente Cr\u00edtico Adulto, Hospital Las Higueras, Talcahuano 4270918, Chile"},{"name":"Escuela de Kinesiolog\u00eda, Universidad Nacional Andr\u00e9s Bello, Sede Concepci\u00f3n, Concepci\u00f3n 8370146, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3176-9149","authenticated-orcid":false,"given":"David","family":"Kraunik","sequence":"additional","affiliation":[{"name":"Unidad de Paciente Cr\u00edtico Adulto, Hospital Las Higueras, Talcahuano 4270918, Chile"},{"name":"Facultad de Medicina, Universidad de Concepci\u00f3n, Concepci\u00f3n 4070386, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila M.","family":"Martins","sequence":"additional","affiliation":[{"name":"AAC&T Research Consulting LTDA, Curitiba 82620-045, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1412-7136","authenticated-orcid":false,"given":"Patricia R. M.","family":"Rocco","sequence":"additional","affiliation":[{"name":"Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Centro de Ci\u00eancias da Sa\u00fade, Avenida Carlos Chagas Filho, 373, Bloco G-014, Ilha Do Fund\u00e3o, Rio de Janeiro 21941-598, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6895-6442","authenticated-orcid":false,"given":"Denise","family":"Battaglini","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy"},{"name":"Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"ref_1","first-page":"e15057","article-title":"Diaphragm and Lung Ultrasonography During Weaning From Mechanical Ventilation in Critically Ill Patients","volume":"13","author":"Gok","year":"2021","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Al-Husinat, L., Jouryyeh, B., Rawashdeh, A., Robba, C., Silva, P., Rocco, P., and Battaglini, D. 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Biol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/20\/2263\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:11:28Z","timestamp":1760112688000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/20\/2263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,11]]},"references-count":43,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["diagnostics14202263"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14202263","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,11]]}}}