Sonographic evaluation of the diaphragm in critically ill patients. Technique and clinical applications
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The use of ultrasonography has become increasingly popular in the everyday management of critically ill patients. It has been demonstrated to be a safe and handy bedside tool that allows rapid hemodynamic assessment and visualization of the thoracic, abdominal and major vessels structures. More recently, M-mode ultrasonography has been used in the assessment of diaphragm kinetics. Ultrasounds provide a simple, non-invasive method of quantifying diaphragmatic movement in a variety of normal and pathological conditions. Ultrasonography can assess the characteristics of diaphragmatic movement such as amplitude, force and velocity of contraction, special patterns of motion and changes in diaphragmatic thickness during inspiration. These sonographic diaphragmatic parameters can provide valuable information in the assessment and follow up of patients with diaphragmatic weakness or paralysis, in terms of patient–ventilator interactions during controlled or assisted modalities of mechanical ventilation, and can potentially help to understand post-operative pulmonary dysfunction or weaning failure from mechanical ventilation. This article reviews the technique and the clinical applications of ultrasonography in the evaluation of diaphragmatic function in ICU patients.
KeywordsBedside ultrasonography Critically ill Diaphragmatic dysfunction
The authors are grateful to Aissam Lyazidi for technical assistance in preparation of the manuscript.
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- 14.Grosu HB, Lee YI, Lee J, Eden E, Eikermann M, Rose K (2012) Diaphragm muscle thinning in mechanically ventilated patients. Chest: PMID: 22722229Google Scholar
- 24.Soilemezi E, Tsagourias M, Talias MA, Soteriades ES, Makrakis V, Zakynthinos E, Matamis D (2012) Sonographic assessment of changes in diaphragmatic kinetics induced by inspiratory resistive loading. Respirology. doi: 10.1111/resp12011
- 26.Vivier E, Mekontso Dessap A, Dimassi S, Vargas F, Lyazidi A, Thille AW, Brochard L (2012) Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation. Intensive Care Med 38:796–803Google Scholar
- 30.Tobin M, Laghi F (1998) Monitoring of respiratory muscle function. In: Tobin M (ed) Principe and practice of respiratory care monitoring. McGraw-Hill, New York, pp 497–544Google Scholar