Evaluation and Clinical Analysis of Extubation Related Indicators （Diaphragmatic Ultrasound，GCS and RCPF） in Patients with Brain Injury Undergoing Tracheotomy

Zhuanling YANG; Yan WU; Qianxi YAN; Mai LI; Xin TANG; Wenli WANG

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Zhuanling YANG, Yan WU, Qianxi YAN, Mai LI, Xin TANG, Wenli WANG. Evaluation and Clinical Analysis of Extubation Related Indicators （Diaphragmatic Ultrasound，GCS and RCPF） in Patients with Brain Injury Undergoing Tracheotomy[J]. Journal of Kunming Medical University.

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Evaluation and Clinical Analysis of Extubation Related Indicators （Diaphragmatic Ultrasound，GCS and RCPF） in Patients with Brain Injury Undergoing Tracheotomy

1.
Department of Rehabilitation Medicine，The Second Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101
2.
School of Rehabilitation Medicine，Kunming Medical University，Kunming Yunnan 650500，China

Received Date: 2026-04-15
Available Online: 2026-04-21

Abstract

Abstract

Objective To investigate the application value of diaphragmatic ultrasound, reflex cough peak flow （RCPF） and Glasgow Coma Scale （GCS） in extubation evaluation of patients with brain injury after tracheotomy. Methods A retrospective analysis was performed on 39 patients with brain injury after tracheotomy admitted to the Rehabilitation Medicine Center of The Second Affiliated Hospital of Kunming Medical University from August 2024 to October 2025. The patients were divided into successful extubation group （19 cases） and a failed extubation group （20 cases） according to extubation outcomes during hospitalization. General clinical data, diaphragm ultrasound parameters, RCPF, GCS and interleukin-6 （IL-6） were collected and all examinations were completed within 24 hours before extubation. Exploratory statistical analyses were conducted using univariate analysis, stepwise binary Logistic regression, and receiver operating characteristic （ROC） curve. Results The diaphragm thickening fraction （DTF）, diaphragm excursion （DE）, RCPF, and GCS in the successful extubation group were significantly higher than those in the failed extubation group （P < 0.05）. There were no significant differences in diaphragm thickness at end inspiration （DTei） or IL-6 between the two groups （P > 0.05）. Logistic regression showed that RCPF and GCS were correlated with extubation outcomes （P < 0.05）. The area under the ROC curve （AUC） of combined evaluation of the two indicators was 0.911, with a sensitivity of 89.50% and a specificity of 75.00%, indicating satisfactory model fitting and validation performance. Conclusion This study demonstrates that DTF, DE, RCPF, and GCS score are all associated with extubation outcomes, among which the combined evaluation of RCPF and GCS score presents favorable predictive efficacy.
- Brain injury,
- Tracheotomy,
- Extubation assessment,
- Diaphragmatic ultrasound,
- Glasgow coma scale,
- Reflex cough peak flow

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References(28)

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