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Table 2 Variables associated with an increase in diaphragm function* and a decrease or no change in diaphragm function between the two measurements

From: Severe but reversible impaired diaphragm function in septic mechanically ventilated patients

 

Increase in diaphragm function

n = 40

Decrease or no change in diaphragm function

n = 52

p

Time between intubation and second measure, days

5 (3–6)

4 (2–6)

0.163

Time between 2 measures, days

4 (3–5)

3 (1–5)

0.134

Sepsis at inclusion, n (%)

29 (73)

22 (42)

0.004

Age, years

61 (49–72)

63 (54–71)

0.425

Male sex, n (%)

22 (55)

34 (65)

0.312

Body mass index, kg m−2

24 (21–25)

25 (23–28)

0.036

SAPS2 at inclusion

58 (35–66)

54 (45–64)

0.831

SOFA at inclusion

9 (5–11)

10 (7–12)

0.301

Comorbidities, n (%)

 Active smoking

20 (50)

25 (48)

0.855

 COPD

9 (23)

12 (23)

0.948

 Diabetes

11 (28)

14 (27)

0.951

 Cirrhosis

7 (18)

10 (19)

0.832

Primary reason for ventilation, n (%)

 Acute respiratory failure

28 (70)

27 (52)

0.080

 Shock

5 (13)

7 (13)

0.892

 Cardiac arrest

1 (3)

6 (12)

0.105

 Coma

6 (15)

12 (23)

0.333

Biological variables

   

 PCT at inclusion, ng/ml

3 (0.3–20)

1.7 (0.9–7.3)

0.909

 Blood lactate at inclusion, mmol.l−1

1.8 (1.2–3.2)

2.1 (1.4–2.9)

0.838

 PaO2/FiO2 at inclusion

230 (160–305)

226 (162–306)

0.940

 PaO2/FiO2 at second measure

280 (202–327)

260 (220–333)

0.990

Sedation

   

 Hypnotics at inclusion (propofol or midazolam), n (%)

33 (100) a

44 (100) c

1.000

 Sufentanyl at inclusion, n (%)

29 (88) a

38 (86) c

1.000

 Hypnotics at second measure (propofol or midazolam), n (%)

19 (56) b

16 (40) d

0.130

 Sufentanyl at second measure, n (%)

9 (26) b

14 (35) d

0.808

Organ support

   

 Vasopressors, n (%)

28 (70)

38 (73)

0.745

Diaphragm function

   

 Ptr,stim at inclusion, cmH2O

5.8 (4.0–8.0)

10.2 (7.0–14.3)

 < 0.001

 Ptr,stim at second measure, cmH2O

10.5 (7.0–12.5)

6.9 (4.5–9.4)

0.002

 Absolute change in Ptr,stim, cmH2O

3.4 (1.8–4.8)

– 1.5 (– 4.9 to – 0.6)

 < 0.001

 Relative change in Ptr,stim, %

59 (32–78)

– 19 (– 43 to – 7)

 < 0.001

 End-expiratory diaphragm thickness at inclusion, mm

2.3 (1.9–2.9) e

2.1 (1.7–2.5) f

0.484

 End-expiratory diaphragm thickness at second measure, mm

1.9 (1.5–2.3) e

2.0 (1.7–2.2) f

0.565

  1. Categorical variables are expressed as absolute value (%) and continuous variables as median (interquartile range)
  2. * Increase in diaphragm function is defined as an increase > 10% of the change of endotracheal tube pressure induced by bilateral phrenic nerve stimulation during airway occlusion (Ptr,stim) between first measure at inclusion and second measure after switch to pressure support mode
  3. SOFA: Sepsis-related Organ Failure Assessment; SAPS 2: New Simplified Acute Physiology Score; COPD: chronic obstructive pulmonary disease; PCT: procalcitonin; PaO2/FiO2: partial arterial oxygen tension on inspired oxygen fraction ratio; Ptr,stim: endotracheal tube pressure induced by bilateral phrenic nerve stimulation during airway occlusion
  4. a Data available for 33/40 patients, b data available for 34/40 patients
  5. c Data available for 44/52 patients, d data available for 40/52 patients
  6. e Data available for 28/40 patients
  7. f Data available for 30/52 patients