Value of diaphragm ultrasound and inflammatory factors in predicting the outcome of ARDS patients

NIU Li; WU Dan; LI Wan; MA Ping

doi:10.20258/j.cnki.1006-9011.2025.08.017

Abstract：Objective To analyze the predictive value of diaphragm ultrasound parameters combined with serum inflammatory factors in the outcome of mechanical ventilation in patients with acute respiratory distress syndrome(ARDS).Methods 109 patients with ARDS who received invasive mechanical ventilation intervention were selected.Diaphragmatic ultrasonography was performed in all patients before the spontaneous breathing test.The ultrasonography parameters such as diaphragmatic activity(DE),diaphragmatic thickness rate(DTF),shallow rapid breathing index(RSBI)and other parameters were recorded.Inter-leukin-6(IL-6)and high sensitive C-reactive protein(hs-CRP)levels were also measured.Patients were divided into failure group(n=39)and success group(n=70)according to the outcome of withdrawal.The relevant clinical data,diaphragm ultra-sound parameters and serum inflammatory factors of the two groups were compared.Logistic regression analysis was performed to analyze the relationship between diaphragm ultrasound parameters,serum inflammatory factors and the outcome of the patient's withdrawal.Receiver operating characteristic curve(ROC)was amployed to evaluate the value of diaphragm ultrasound param-eters combined with serum inflammatory factors in predicting the outcome of ARDS patients with mechanical ventilation.Results The mechanical ventilation time of the failed group was longer than that of the successful group,and the difference was statistically significant(P<0.05).Compared with the successful group,the respiratory rate/DTF(DTF-RSBI)and respiratory rate/DE(DE-RSBI)in the failure group were higher,and the levels of serum inflammatory factors(IL-6,hs-CRP)were higher.The differences were statistically significant(P<0.05).Logistic regression analysis showed that DTF-RSBI,DE-RSBI and IL-6 were the related factors of withdrawal failure after mechanical ventilation in ARDS patients(P<0.05).ROC curve was estab-lished to analyze the differentiation of each model,and the results showed that the AUC of DTF-RSBI,DE-RSBI,IL-6 and com-bined indexes was 0.925,0.884,0.858 and 0.953,respectively.The above indexes had certain predictive value for the out-come of ARDS mechanical ventilation patients.The AUC was the largest and the accuracy was higher in the combined prediction.Conclusion The combination of phrenic ultrasonography parameters and serum inflammatory factors in predicting the outcome of ARDS patients with mechanical ventilation has certain clinical reference value.