“…Diaphragmatic excursion (DE) was evaluated using a low-frequency curved probe (4C-RS, 2–5 MHz) placed at one of the lower intercostal spaces in the right anterior and left midaxillary lines. Computed tomography (CT) score was evaluated by a radiologist who was blinded to clinical data [3] , [4] . Fig.…”
Section: Methodsmentioning
confidence: 99%
“…Therefore, it is essential to have accurate and simple tools for monitoring patient’s response to NIV and facilitating the decision and timing of invasive mechanical ventilation. Assessment of diaphragmatic function provides an excellent tool for predicting the outcomes of patients with COVID-19 on admission and during weaning [3] , [4] . Increased activity of the intercostal muscles was observed in patients with respiratory failure and correlated with the degree of diaphragmatic dysfunction in non-COVID-19 patients [5] .…”
“…Diaphragmatic excursion (DE) was evaluated using a low-frequency curved probe (4C-RS, 2–5 MHz) placed at one of the lower intercostal spaces in the right anterior and left midaxillary lines. Computed tomography (CT) score was evaluated by a radiologist who was blinded to clinical data [3] , [4] . Fig.…”
Section: Methodsmentioning
confidence: 99%
“…Therefore, it is essential to have accurate and simple tools for monitoring patient’s response to NIV and facilitating the decision and timing of invasive mechanical ventilation. Assessment of diaphragmatic function provides an excellent tool for predicting the outcomes of patients with COVID-19 on admission and during weaning [3] , [4] . Increased activity of the intercostal muscles was observed in patients with respiratory failure and correlated with the degree of diaphragmatic dysfunction in non-COVID-19 patients [5] .…”
“…In our current report concerning diaphragmatic excursion in patients with severe COVID-19 [2] , we did not encounter any patient with exaggerated diaphragmatic function and the maximum diaphragmatic excursion was 45- and 37 mm in the right and left sides, respectively. In our earlier report, we evaluated diaphragmatic excursion at weaning from invasive mechanical ventilation; however, we did not assess the patients at hospital admission [3] .…”
mentioning
confidence: 58%
“…We read with interest the recent comment by J Schmitt et al on our study [1] , [2] and thank them for their interest and valuable insights.…”
mentioning
confidence: 87%
“…Unfortunately, we did not record PaCO 2 values during our two studies [2] , [4] ; however, previous literature showed that patients with severe COVID-19 have lower inspiratory effort in comparison to matched non-COVID-19 cohort with respiratory failure, suggesting lower risk of P-SILI in patients with COVID-19 [4] . Furthermore, data from COVID-19 patients showed that PaCO 2 was not significantly lower in patients who later needed mechanical ventilation, and that PaCO 2 showed low accuracy in predicting the need for mechanical ventilation and/or death with area under receiver operating characteristic (95% confidence interval) of 0.57 (0.51 to 0.68) [5] .…”
We aimed to evaluate the ability of parasternal intercostal thickening fraction (PIC TF) to predict the need for mechanical ventilation, and survival in subjects with severe Coronavirus disease-2019 (COVID-19). This prospective observational study included adult subjects with severe COVID-19. The following data were collected within 12 h of admission: PIC TF, respiratory rate oxygenation index, $${{{\text{P}}_{{{\text{aO}}_{{\text{2}}} }} } \mathord{\left/ {\vphantom {{{\text{P}}_{{{\text{aO}}_{{\text{2}}} }} } {{\text{F}}_{{{\text{iO}}_{{\text{2}}} }} }}} \right. \kern-\nulldelimiterspace} {{\text{F}}_{{{\text{iO}}_{{\text{2}}} }} }}$$
P
aO
2
/
F
iO
2
ratio, chest CT, and acute physiology and chronic health evaluation II score. The ability of PIC TF to predict the need for ventilatory support (primary outcome) and a composite of invasive mechanical ventilation and/or 30-days mortality were performed using the area under the receiver operating characteristic (AUC) analysis. Multivariate analysis was done to identify the independent predictors for the outcomes. Fifty subjects were available for the final evaluation. The AUC (95% confidence interval [CI]) for the right and left PIC TF ability to predict the need for ventilator support was 0.94 (0.83–0.99), 0.94 (0.84–0.99), respectively, with a cut off value of > 8.3% and positive predictive value of 90–100%. The AUC for the right and left PIC TF to predict invasive mechanical ventilation and/or 30 days mortality was 0.95 (0.85–0.99) and 0.90 (0.78–0.97), respectively. In the multivariate analysis, only the PIC TF was found to independently predict invasive mechanical ventilation and/or 30-days mortality. In subjects with severe COVID-19, PIC TF of 8.3% can predict the need to ventilatory support with a positive predictive value of 90–100%. PIC TF is an independent risk factor for the need for invasive mechanical ventilation and/or 30-days mortality.
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