Increased days of MV are not without hazards, including barotraumas and ventilator-associated pneumonia. Similarly, premature separation of MV is associated with increased mortality secondary to adverse cardiorespiratory events. Therefore, the time of weaning should be wisely evaluated. There is growing evidence concerning respiratory muscles dysfunction that contributes to difficulty or prolonged liberation from MV.

Researchers aim to evaluate the influence of adding parasternal thickening fraction to the standard weaning criteria and its impact on reintubation

Inclusion Criteria:

• critically ill patient mechanically ventilated for 24 hours or more first spontaneous breathing trial

Exclusion Criteria:

• patient refusal difficult ultrasound views tracheostomized patient neuromuscular disorders

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