Ultrasonography in Assessment of Respiratory Muscles Function: A Systematic Review

Pałac, Małgorzata; Rutka, Magdalena; Wolny, Tomasz; Podgórski, Michał; Linek, Paweł

doi:10.1159/000524785

Cited by 11 publications

(10 citation statements)

References 61 publications

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“…Previous systematic reviews within the field have examined accuracy and usefulness of diaphragmatic ultrasound in predicting weaning outcomes and extubation success with the latest review focusing on diaphragm thickening fraction (DTF) and excursion only (5)(6)(7)(8)(9). A more recent systematic review by Pałac et al (10) aimed to evaluate the utility of respiratory muscle ultrasound imaging for assessing respiratory function and identify ultrasound variables that best correlate with pulmonary parameters. No systematic reviews to date have comprehensively synthesized and analyzed inspiratory respiratory muscle ultrasound methodology (including acquisition and analysis processes) as well as reporting on clinimetric properties (e.g., reliability, measurement error, construct/predictive validity, and responsiveness).…”

Section: E25mentioning

confidence: 99%

Methodological and Clinimetric Evaluation of Inspiratory Respiratory Muscle Ultrasound in the Critical Care Setting: A Systematic Review and Meta-Analysis

Truong

Abo

Whish-Wilson

et al. 2023

Critical Care Medicine

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in the Critical Care Setting: A Systematic Review and Meta-Analysis OBJECTIVE: Significant variations exist in the use of respiratory muscle ultrasound in intensive care with no society-level consensus on the optimal methodology. This systematic review aims to evaluate, synthesize, and compare the clinimetric properties of different image acquisition and analysis methodologies.DATA SOURCES: Systematic search of five databases up to November 24, 2021. STUDY SELECTION:Studies were included if they enrolled at least 50 adult ICU patients, reported respiratory muscle (diaphragm or intercostal) ultrasound measuring either echotexture, muscle thickness, thickening fraction, or excursion, and evaluated at least one clinimetric property. Two independent reviewers assessed titles, abstracts, and full text against eligibility.DATA EXTRACTION: Study demographics, ultrasound methodologies, and clinimetric data.DATA SYNTHESIS: Sixty studies, including 5,025 patients, were included with 39 studies contributing to meta-analyses. Most commonly measured was diaphragm thickness (DT) or diaphragm thickening fraction (DTF) using a linear transducer in B-mode, or diaphragm excursion (DE) using a curvilinear transducer in M-mode. There are significant variations in imaging methodology and acquisition across all studies. Inter-and intrarater measurement reliabilities were generally excellent, with the highest reliability reported for DT (ICC, 0.98; 95% CI, 0.94-0.99). Pooled data demonstrated acceptable to excellent accuracy for DT, DTF, and DE to predicting weaning outcome after 48 to 72 hours postextubation (DTF AUC, 0.79; 95% CI, 0.73-0.85). DT imaging was responsive to change over time. Only three eligible studies were available for intercostal muscles. Intercostal thickening fraction was shown to have excellent accuracy of predicting weaning outcome after 48-hour postextubation (AUC, 0.84; 95% CI, 0.78-0.91). CONCLUSIONS:Diaphragm muscle ultrasound is reliable, valid, and responsive in ICU patients, but significant variation exists in the imaging acquisition and analysis methodologies. Future work should focus on developing standardized protocols for ultrasound imaging and consider further research into the role of intercostal muscle imaging.

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Section: E25mentioning

confidence: 99%

Methodological and Clinimetric Evaluation of Inspiratory Respiratory Muscle Ultrasound in the Critical Care Setting: A Systematic Review and Meta-Analysis

Truong

Abo

Whish-Wilson

et al. 2023

Critical Care Medicine

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“…However, both too much and too little unloading may have deleterious effects [3]. Sonographic measurement of the diaphragm thickening fraction (DTF) has been adapted to monitor respiratory effort during mechanical ventilation and weaning [4,5], although multiple other methods are available for this purpose. The assessment of DTF in the context of non-invasive respiratory support is less well studied, although its ability to predict non-invasive ventilation failure has been shown [6,7].…”

Section: Introductionmentioning

confidence: 99%

Mask CPAP Increases Diaphragm Thickening Fraction in Healthy Subjects

Lindner

Teichert

Hoermann

et al. 2023

Preprint

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Purpose This is a physiological study to determine the effect of continuous positive airway pressure and inspiratory support pressure on respiratory effort measured by diaphragm thickening fraction (DTF) during non-invasive respiratory support in healthy volunteers. Materials and Methods DTF was measured in spontaneously breathing, healthy volunteers during 4 phases: (I) Without connection to a ventilator, (II) on a ventilator without any applied pressures, (III) with continuous positive airway pressure of 5 cmH2O and (IV) with additional inspiratory support pressure of 5 cmH2O. Results 29 individuals agreed to participate. DTF was similar during the first two phases (32 ± 13% and 35 ± 22%). A considerable increase in DTF to 51 ± 21% was noted in phase III. The introduction of inspiratory support pressure during phase IV led to a reduction in DTF back to 36 ± 23% (p < 0.001). Tidal volume and minute ventilation were both slightly higher in phase IV compared to phase III. Conclusion Continuous positive airway pressure without inspiratory support pressure increases respiratory effort measured by DTF in healthy subjects. Further research is required to investigate this phenomenon in patients with acute respiratory failure.

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“…Spirometry, as a gold standard of assessing respiratory function ( Durmic et al, 2015 ), allows reproducible and standardised assessment of pulmonary function ( Lazovic-Popovic et al, 2016 ). However, spirometry performance is the result of many factors (including airway obstruction, respiratory compliance, and RM strength) that do not allow direct analysis of the RMs ( Pałac et al, 2022 ). In contrast, ultrasound (US) imaging can directly and reliably assess the thickness, excursion, and shear modulus (elasticity) of the RMs ( Pałac et al, 2022 ; Zhu et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, spirometry performance is the result of many factors (including airway obstruction, respiratory compliance, and RM strength) that do not allow direct analysis of the RMs ( Pałac et al, 2022 ). In contrast, ultrasound (US) imaging can directly and reliably assess the thickness, excursion, and shear modulus (elasticity) of the RMs ( Pałac et al, 2022 ; Zhu et al, 2019 ). Pałac et al (2022) also confirmed the reliability of RMs US measurements in adolescent football players.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, ultrasound (US) imaging can directly and reliably assess the thickness, excursion, and shear modulus (elasticity) of the RMs ( Pałac et al, 2022 ; Zhu et al, 2019 ). Pałac et al (2022) also confirmed the reliability of RMs US measurements in adolescent football players. In the literature, some studies have shown the relationship between US parameters of the RMs and spirometry parameters in different populations ( Pałac & Linek, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

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Relationship between respiratory muscles ultrasound parameters and running tests performance in adolescent football players. A pilot study

Pałac

Sikora

Wolny

et al. 2023

PeerJ

Self Cite

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Purpose Assessing the relationship between ultrasound imaging of respiratory muscles during tidal breathing and running tests (endurance and speed) in adolescent football players. Methods Ultrasound parameters of the diaphragm and intercostal muscles (shear modulus, thickness, excursion, and velocity), speed (30-m distance), and endurance parameters (multi-stage 20-m shuttle run test) were measured in 22 male adolescent football players. The relation between ultrasound and running tests were analysed by Spearman’s correlation. Results Diaphragm shear modulus at the end of tidal inspiration was moderately negatively (R = − 0.49; p = 0.2) correlated with the speed score at 10 m. The diaphragm and intercostal muscle shear modulus ratio was moderately to strongly negatively correlated with the speed score at 10 m and 30 m (about R = − 0.48; p = 0.03). Diaphragm excursion was positively correlated with the speed score at 5 m (R = 0.46; p = 0.04) and 10 m (R = 0.52; p = 0.02). Diaphragm velocity was moderately positively correlated with the speed score at 5 m (R = 0.42; p = 0.06) and 30 m (R = 0.42; p = 0.07). Ultrasound parameters were not significantly related to all endurance parameters (R ≤ 0.36; p ≥ 0.11). Conclusions Ultrasound parameters of the respiratory muscles are related to speed score in adolescent football players. The current state of knowledge does not allow us to clearly define how important the respiratory muscles’ ultrasound parameters can be in predicting some performance parameters in adolescent athletes.

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Ultrasonography in Assessment of Respiratory Muscles Function: A Systematic Review

Cited by 11 publications

References 61 publications

Methodological and Clinimetric Evaluation of Inspiratory Respiratory Muscle Ultrasound in the Critical Care Setting: A Systematic Review and Meta-Analysis

Methodological and Clinimetric Evaluation of Inspiratory Respiratory Muscle Ultrasound in the Critical Care Setting: A Systematic Review and Meta-Analysis

Mask CPAP Increases Diaphragm Thickening Fraction in Healthy Subjects

Relationship between respiratory muscles ultrasound parameters and running tests performance in adolescent football players. A pilot study

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