Ultrasonography for Screening and Follow-Up of Diaphragmatic Dysfunction in the ICU

Abstract

The ICU-acquired DD usually improves before ICU discharge but might constitute a marker for greater disease severity. The present preliminary results require confirmation in a larger prospective multicenter study.

Point of care diaphragm ultrasound in infants with bronchiolitis: A prospective study

“…Diaphragmatic ultrasound has been proven to be a noninvasive, easily performed and learned with a short learning curve, and a reliable tool in assessing diaphragm function . Most of the described studies have been performed in adult patients in intensive care unit (either mechanically ventilated or post operative patients) and very few studies have been performed in children …”

“…Several parameters have been studied to evaluate diaphragm function: 11 studies (51, 53, 57‐79) measured diaphragmatic thickness, seven of them assessing diaphragmatic contractility as thickening fraction. Five studies measured respiratory excursion of the diaphragm in M‐mode, five studies measured diaphragm excursion in B‐mode …”

Ultrasonography evaluation during the weaning process: the heart, the diaphragm, the pleura and the lung

“…Ultrasonography may be particularly useful to monitor recovery over time. Mariani et al studied diaphragmatic excursion in 34 patients with prolonged (>7 days) mechanical ventilation; repeated measurements were performed in seven patients with bilateral dysfunction (E < 11 mm) [39]. Progressive improvement of E was observed over time in 71 % of cases.…”

Ultrasound to assess diaphragmatic function in the critically ill—a critical perspective

“…In ICU patients, it may already be of clinical value for instance to demonstrate severe diaphragm weakness (17,18) and patient-ventilator asynchrony (19). However, it should be kept in mind that clinicians should not be over enthusiastic regarding the interpretation of results obtained by diaphragm ultrasound.…”