Speckle tracking ultrasonography as a new tool to assess diaphragmatic function: a feasibility study

Fritsch, Sebastian; Goetzenich, Andreas; Marx, Gernot; Autschbach, R.; Heunks, Leo; Bickenbach, Johannes; Bruells, Christian S.

doi:10.14366/usg.21044

Cited by 10 publications

(8 citation statements)

References 32 publications

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“…Fourth, our initial aim was to explore whether speckle tracking ultrasonography could accurately assess diaphragm function. However, before the research started, Fritsch SJ et al published similar research, demonstrating that speckle tracking ultrasonography depicts alterations in diaphragmatic function after surgery better than 2D ultrasonographic measurements [29]. Therefore, we modified the protocol.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, 2D measurements can only assess the deformation of the diaphragmatic musculature in the transverse direction; longitudinal measures of the contraction direction cannot be obtained. Several studies have been conducted to explore speckle tracking as a promising approach to evaluating diaphragmatic contractility in healthy subjects [15,18,29,35,36]; however, few studies have reported the use of speckle tracking to assess diaphragmatic contractility among mechanically ventilated patients. Fritsch and colleagues reported the feasibility of diaphragmatic speckle tracking in a cohort of 20 patients after an aortocoronary bypass graft procedure [29].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have been conducted to explore speckle tracking as a promising approach to evaluating diaphragmatic contractility in healthy subjects [15,18,29,35,36]; however, few studies have reported the use of speckle tracking to assess diaphragmatic contractility among mechanically ventilated patients. Fritsch and colleagues reported the feasibility of diaphragmatic speckle tracking in a cohort of 20 patients after an aortocoronary bypass graft procedure [29]. This finding was in accordance with our study.…”

Section: Discussionmentioning

confidence: 99%

“…Oppersma and colleagues used diaphragmatic electric activity and transdiaphragmatic pressures to compare the ability of different diaphragmatic ultrasound technologies to estimate diaphragmatic contraction and found that speckle tracking is superior to conventional parameters [36]. Fritsch and colleagues also suggested that speckle tracking ultrasonography was able to depict alterations in diaphragmatic function better than conventional ultrasonographic measurements [29]. In our research, significant differences in DLS values were noted patients with eupnoea, deep inspiration, and mechanical ventilation, and these differences were consistent with the physiological and pathophysiological changes in the diaphragm.…”

Section: Discussionmentioning

confidence: 99%

“…The DLS differences between sexes were compared using the Mann-Whitney test. Based on previously published research, the sample size for this exploratory investigation was predicted to be 25 healthy volunteers and 20 critically ill mechanically ventilated patients [29,30]. For Study B, receiver operating characteristic curves (ROC) were used to evaluate the performance of predicting weaning outcome.…”

Section: Statistical Analysesmentioning

confidence: 99%

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Comparison of assessment of diaphragm function using speckle tracking between patients with successful and failed weaning: a multicentre, observational, pilot study

Xiao

Yan

et al. 2022

BMC Pulm Med

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Background Diaphragmatic ultrasound has been increasingly used to evaluate diaphragm function. However, current diaphragmatic ultrasound parameters provide indirect estimates of diaphragmatic contractile function, and the predictive value is controversial. Two-dimensional (2D) speckle tracking is an effective technology for measuring tissue deformation and can be used to measure diaphragm longitudinal strain (DLS) to assess diaphragm function. The purpose of this study was to determine the feasibility and reproducibility of DLS quantification by 2D speckle tracking and to determine whether maximal DLS could be used to predict weaning outcomes. Methods This study was performed in the intensive care unit of two teaching hospitals, and was divided into two studies. Study A was a prospective study to evaluate the feasibility, reliability, and repeatability of speckle tracking in assessing DLS in healthy subjects and mechanically ventilated patients. Study B was a multicentre retrospective study to assess the use of maximal DLS measured by speckle tracking in predicting weaning outcomes. Results Twenty-five healthy subjects and twenty mechanically ventilated patients were enrolled in Study A. Diaphragmatic speckle tracking was easily accessible. The intra- and interoperator reliability were good to excellent under conditions of eupnoea, deep breathing, and mechanical ventilation. The intraclass correlation coefficient (ICC) ranged from 0.78 to 0.95. Ninety-six patients (fifty-nine patients were successfully weaned) were included in Study B. DLS exhibited a fair linear relationship with both the diaphragmatic thickening fraction (DTF) (R2 = 0.73, p < 0.0001) and diaphragmatic excursion (DE) (R2 = 0.61, p < 0.0001). For the prediction of successful weaning, the areas under the ROC curves of DLS, diaphragmatic thickening fraction DTF, RSBI, and DE were 0.794, 0.794, 0.723, and 0.728, respectively. The best cut-off value for predicting the weaning success of DLS was less than -21%, which had the highest sensitivity of 89.19% and specificity of 64.41%. Conclusions Diaphragmatic strain quantification using speckle tracking is easy to obtain in healthy subjects and mechanically ventilated patients and has a high predictive value for mechanical weaning. However, this method offers no advantage over RSBI. Future research should assess its value as a predictor of weaning. Trial registration This study was registered in the Chinese Clinical Trial Register (ChiCTR), ChiCTR2100049816. Registered 10 August 2021. http://www.chictr.org.cn/showproj.aspx?proj=131790

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Section: Discussionmentioning

confidence: 99%