2026-04-13T03:01:17Zhttps://recercat.cat/oai/request

oai:recercat.cat:10230/717092025-10-30T01:53:00Zcom_2072_6col_2072_452952

00925njm 22002777a 4500 dc Parrilla-Gómez, Francisco José author Roche-Campo, Ferran author Italiano, Stefano author Parrilla-Gómez, Andrés author Morán, Indalecio author Mancebo, Jordi author Maraffi, Tommaso author 2025-10-29T17:06:25Z 2025-10-29T17:06:25Z 2024 2025-10-29T17:06:25Z Introduction: Weaning patients from mechanical ventilation is crucial in the management of acute respiratory failure (ARF). Spontaneous breathing trials (SBT) are used to assess readiness for extubation, but extubation failure remains a challenge. Diaphragmatic function, measured by electrical activity of the diaphragm (EAdi), may provide insights into weaning outcomes. Materials and methods: This prospective, observational study included difficult-to-wean patients undergoing invasive mechanical ventilation. EAdi was recorded before, during, and after extubation. Patients were categorized into extubation success and failure groups based on reintubation within 48 h. Statistical analysis assessed EAdi patterns and predictive value. Results: Thirty-one patients were analyzed, with six experiencing extubation failure. Overall, EAdi increased significantly between the phases before the SBT, the SBT and post-extubation period, up to 24 h (p < 0.001). EAdi values were higher in the extubation failure group during SBT (p = 0.01). An EAdi > 30 μV during SBT predicted extubation failure with 92% sensitivity and 67% specificity. Multivariable analysis confirmed EAdi as an independent predictor of extubation failure. Conclusions: In difficult-to-wean patients, EAdi increases significantly between the phases before the SBT, the SBT and post-extubation period and is significantly higher in patients experiencing extubation failure. An EAdi > 30 μV during SBT may enhance extubation failure prediction compared to conventional parameters. Advanced monitoring of diaphragmatic function could improve weaning outcomes in critical care settings. http://hdl.handle.net/10230/71709 Weaning Extubation Electrical activity of the diaphragm Mechanical ventilation Spontaneous breathing trial Time course of electrical activity of the diaphragm (EAdi) in the peri extubation period and its role as predictor of extubation failure in difficult to wean patients