Background: Mechanical ventilation is an essential life-support measure in intensive care units (ICUs). However, prolonged mechanical ventilation is associated with multiple complications, and timely weaning is crucial for improving patient outcomes. Traditional weaning predictors have limitations in neonatal populations. Recently, transthoracic ultrasonography has emerged as a non-invasive tool to assess diaphragmatic function and potentially predict weaning success. Nevertheless, studies focusing on its application in neonatal populations remain limited, necessitating further investigation. Methods: This study was a prospective cross-sectional study included 40 neonates on MV at NICU at Minia Maternity and Children University Hospitals during a period from January 2024 to January 2025 All patients were candidates for weaning and have been given a chance for spontaneous breathing trial (SBT), during which transthoracic US was performed for them. The diaphragmatic thickening fraction (DTF), IVC diameter, cardiac contractility, and RSBI were assessed. Results: Neonates who failed weaning had significantly lower diaphragmatic thickness at inspiration (DTI) (1.69±0.07 mm) compared to those who succeeded (1.9±0.10 mm, p<0.001). Diaphragmatic thickness at expiration (DTE) was slightly lower in failed cases (1.46±0.08 mm) than in successful cases (1.49±0.06 mm), but this difference was not statistically significant (p=0.31). Conclusions: Successful Extubation from mechanical ventilation depends upon many factors related to the clinical state and investigations of the case. Transthoracic ultrasound had an important role in predicting weaning and successful extubating from mechanical ventilation in NICU. Failed cases had lower diaphragmatic thickness at inspiration (DTI), diaphragmatic thickening fraction (DTF), contractility and smaller inferior vana cava (IVC) diameter.
Abdelrazic et al. (2026) studied this question.