• Jie Zhang, Qian Xie, Rong Jiang, Yang Yang, Yuting Yang, Chaoqi Zhou, Wei Zhang, Tian Zhang, Yixin Liu, and Huiming Yao.
• Department of Critical Care Medicine, Medical Center of Anesthesiology and Pain, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
• J Crit Care. 2024 Dec 10; 86: 154983154983.

PurposeThis study aims to evaluate the role of diaphragmatic dysfunction in extubation failure among patients at high risk of reintubation.Material And MethodsThis prospective cohort study was carried out at a intensive care unit in China. Adult patients who had been intubated for more than 24 h and ready for extubation were included in the study if they exhibited a high risk of extubation failure. Diaphragm dysfunction was defined as a diaphragmatic thickening fraction <30 % or diaphragmatic excursion <10 mm. The primary outcome was defined as extubation failure, which includes either reintubation or death within the initial 7 days following extubation.ResultsOut of the 113 patients, 27 (23.89 %) experienced extubation failure, with diaphragm dysfunction diagnosed in 63 (55.75 %) individuals. Patients who failed extubation were significantly more likely to have diaphragm dysfunction (85.19 % vs. 46.51 %, p < 0.01). In the Cox-proportional hazards regression analysis, diaphragm dysfunction and the Medical Research Council score were found to be associated with extubation failure. The adjusted hazard ratios were 4.56 [95 % CI: 1.56-13.33] and 0.93 [95 % CI: 0.88-0.99]. Both variables were closely correlated with extubation failure showing statistical significance.ConclusionDiaphragm dysfunction could contribute to an elevated extubation failure rate.Copyright © 2024 Elsevier Inc. All rights reserved.

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