A Study Of Diaphragmatic Ultrasound In Critically Ill Patients With Therapeutic Theophylline Trials

Document Type : Original Article

Authors

1 Department of internal Medicine ,Assiut University

2 Department of chest disease and tuberculosis, , Assiut University

Abstract

Background and aim: This study was conducted to assess response of critically ill patients with diaphragmatic dysfunction to theophylline treatment and the impact of diaphragmatic function on hospital stay & mortality.
Patients and Methods: an interventional, randomized controlled trial , that included 46 patients with diaphragmatic dysfunction, were divided randomly into two groups: study group, received theophylline and control group, received only their usual medications. All patients in this study were subjected to medical history taking, physical examination, different laboratory investigations, diaphragmatic US prior to and after theophylline treatment.
Results: In the study group there was significant increase in each of thickening fraction (16.95 ± 1.49 vs. 23.69 ± 7.21 (%); p< 0.001) and excursion (8.65 ± 1.13 vs. 13.32 ± 4.15 (mm) ; p<0.001). Patients of the study group had significantly shorter ICU stay (10.17 ± 4.15 vs. 14.34 ± 7.04 (days); p= 0.01). Survivors had significantly higher baseline thickening fraction (17.47 ± 1.12 vs. 16.04 ± 1.87 (%); p< 0.001) and excursion (8.85 ± 1.10 vs. 7.70 ± 1.60 (mm); p< 0.001) in comparison to patients who died. Diaphragmatic function can accurately predict mortality in critically ill patients at cutoff point < 12.5%, thickening fraction and at cutoff point < 8 mm, excursion with overall accuracy 70.6% and 74.1% respectively.
Conclusion: Theophylline in critically ill patients was shown to improve diaphragmatic function and has favorable outcomes as decrease duration of ICU stay. Diaphragmatic thickening fraction and excursion can be used as a predictor tool of mortality in ICU.

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