1. To diagnose DD DE < 1.0 cm1313 Kim WY, Suh HJ, Hong SB, Koh Y, Lim CM. Diaphragm dysfunction assessed by ultrasonography: influence on weaning from mechanical ventilation. Crit Care Med. 2011;39(12):2627-2630. https://doi.org/10.1097/CCM.0b013e3182266408 https://doi.org/10.1097/CCM.0b013e318226...
,4848 Valette X, Seguin A, Daubin C, Brunet J, Sauneuf B, Terzi N, et al. Diaphragmatic dysfunction at admission in intensive care unit: the value of diaphragmatic ultrasonography. Intensive Care Med. 2015;41(3):557-559. https://doi.org/10.1007/s00134-014-3636-6 https://doi.org/10.1007/s00134-014-3636-...
,4949 Mariani LF, Bedel J, Gros A, Lerolle N, Milojevic K, Laurent V, et al. Ultrasonography for Screening and Follow-Up of Diaphragmatic Dysfunction in the ICU: A Pilot Study. J Intensive Care Med. 2016;31(5):338-343. https://doi.org/10.1177/0885066615583639 https://doi.org/10.1177/0885066615583639...
TF < 20-29%4545 Dubé BP, Dres M, Mayaux J, Demiri S, Similowski T, Demoule A. Ultrasound evaluation of diaphragm function in mechanically ventilated patients: comparison to phrenic stimulation and prognostic implications. Thorax. 2017;72(9):811-818. https://doi.org/10.1136/thoraxjnl-2016-209459 https://doi.org/10.1136/thoraxjnl-2016-2...
,5050 Lu Z, Xu Q, Yuan Y, Zhang G, Guo F, Ge H. Diaphragmatic Dysfunction Is Characterized by Increased Duration of Mechanical Ventilation in Subjects With Prolonged Weaning. Respir Care. 2016;61(10):1316-1322. https://doi.org/10.4187/respcare.04746 https://doi.org/10.4187/respcare.04746...
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DD (DE < 1.0 cm): associated with high mortality rate (60%) in patients with DD and ARF4848 Valette X, Seguin A, Daubin C, Brunet J, Sauneuf B, Terzi N, et al. Diaphragmatic dysfunction at admission in intensive care unit: the value of diaphragmatic ultrasonography. Intensive Care Med. 2015;41(3):557-559. https://doi.org/10.1007/s00134-014-3636-6 https://doi.org/10.1007/s00134-014-3636-...
; predicted weaning outcome1313 Kim WY, Suh HJ, Hong SB, Koh Y, Lim CM. Diaphragm dysfunction assessed by ultrasonography: influence on weaning from mechanical ventilation. Crit Care Med. 2011;39(12):2627-2630. https://doi.org/10.1097/CCM.0b013e3182266408 https://doi.org/10.1097/CCM.0b013e318226...
,5050 Lu Z, Xu Q, Yuan Y, Zhang G, Guo F, Ge H. Diaphragmatic Dysfunction Is Characterized by Increased Duration of Mechanical Ventilation in Subjects With Prolonged Weaning. Respir Care. 2016;61(10):1316-1322. https://doi.org/10.4187/respcare.04746 https://doi.org/10.4187/respcare.04746...
; and DD (TF < 29%) associated with longer ICU LOS, prolonged MV, and increased mortality4545 Dubé BP, Dres M, Mayaux J, Demiri S, Similowski T, Demoule A. Ultrasound evaluation of diaphragm function in mechanically ventilated patients: comparison to phrenic stimulation and prognostic implications. Thorax. 2017;72(9):811-818. https://doi.org/10.1136/thoraxjnl-2016-209459 https://doi.org/10.1136/thoraxjnl-2016-2...
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2. To assess atrophy of the diaphragm during MV Tdi-exp decreases 6.0-7.5%/day of MV (especially on CMV).1818 Zambon M, Beccaria P, Matsuno J, Gemma M, Frati E, Colombo S, et al. Mechanical Ventilation and Diaphragmatic Atrophy in Critically Ill Patients: An Ultrasound Study. Crit Care Med. 2016;44(7):1347-1352. https://doi.org/10.1097/CCM.0000000000001657 https://doi.org/10.1097/CCM.000000000000...
,2828 Cohn D, Benditt JO, Eveloff S, McCool FD. Diaphragm thickening during inspiration. J Appl Physiol (1985). 1997;83(1):291-296. https://doi.org/10.1152/jappl.1997.83.1.291 https://doi.org/10.1152/jappl.1997.83.1....
,5252 Grosu HB, Lee YI, Lee J, Eden E, Eikermann M, Rose KM. Diaphragm muscle thinning in patients who are mechanically ventilated. Chest. 2012;142(6):1455-1460. https://doi.org/10.1378/chest.11-1638 https://doi.org/10.1378/chest.11-1638...
Tdi-exp is > 10% lower in 44% of patients and unchanged in 44%1212 Goligher EC, Fan E, Herridge MS, Murray A, Vorona S, Brace D, et al. Evolution of Diaphragm Thickness during Mechanical Ventilation. Impact of Inspiratory Effort. Am J Respir Crit Care Med. 2015;192(9):1080-1088. https://doi.org/10.1164/rccm.201503-0620OC https://doi.org/10.1164/rccm.201503-0620...
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Atrophy of the diaphragm (Tdi-exp ⇓ > 10%) associated with ⇑ MV1515 Schepens T, Verbrugghe W, Dams K, Corthouts B, Parizel PM, Jorens PG. The course of diaphragm atrophy in ventilated patients assessed with ultrasound: a longitudinal cohort study. Crit Care. 2015;19:422. https://doi.org/10.1186/s13054-015-1141-0 https://doi.org/10.1186/s13054-015-1141-...
,6464 Goligher EC, Dres M, Fan E, Rubenfeld GD, Scales DC, Herridge MS, et al. Mechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes. Am J Respir Crit Care Med. 2018;197(2):204-213. https://doi.org/10.1164/rccm.201703-0536OC https://doi.org/10.1164/rccm.201703-0536...
, ⇑ ICU admission, and ⇑ risk of complications6464 Goligher EC, Dres M, Fan E, Rubenfeld GD, Scales DC, Herridge MS, et al. Mechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes. Am J Respir Crit Care Med. 2018;197(2):204-213. https://doi.org/10.1164/rccm.201703-0536OC https://doi.org/10.1164/rccm.201703-0536...
Diaphragmatic hypertrophy (Tdi-exp ⇑ > 10%) - associated with increased duration of MV3939 Kantarci F, Mihmanli I, Demirel MK, Harmanci K, Akman C, Aydogan F, et al. Normal diaphragmatic motion and the effects of body composition: determination with M-mode sonography. J Ultrasound Med. 2004;23(2):255-260. https://doi.org/10.7863/jum.2004.23.2.255 https://doi.org/10.7863/jum.2004.23.2.25...
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3. To predict weaning from MV DE < 1.0-1.4 cm1313 Kim WY, Suh HJ, Hong SB, Koh Y, Lim CM. Diaphragm dysfunction assessed by ultrasonography: influence on weaning from mechanical ventilation. Crit Care Med. 2011;39(12):2627-2630. https://doi.org/10.1097/CCM.0b013e3182266408 https://doi.org/10.1097/CCM.0b013e318226...
,4040 Dres M, Dubé BP, Mayaux J, Delemazure J, Reuter D, Brochard L, et al. Coexistence and Impact of Limb Muscle and Diaphragm Weakness at Time of Liberation from Mechanical Ventilation in Medical Intensive Care Unit Patients. Am J Respir Crit Care Med. 2017;195(1):57-66. https://doi.org/10.1164/rccm.201602-0367OC https://doi.org/10.1164/rccm.201602-0367...
,5353 Jiang JR, Tsai TH, Jerng JS, Yu CJ, Wu HD, Yang PC. Ultrasonographic evaluation of liver/spleen movements and extubation outcome. Chest. 2004;126(1):179-185. https://doi.org/10.1016/S0012-3692(15)32912-3 https://doi.org/10.1016/S0012-3692(15)32...
,5454 Spadaro S, Grasso S, Mauri T, Dalla Corte F, Alvisi V, Ragazzi R, et al. Can diaphragmatic ultrasonography performed during the T-tube trial predict weaning failure? The role of diaphragmatic rapid shallow breathing index. Crit Care. 2016;20(1):305. https://doi.org/10.1186/s13054-016-1479-y https://doi.org/10.1186/s13054-016-1479-...
,6262 Farghaly S, Hasan AA. Diaphragm ultrasound as a new method to predict extubation outcome in mechanically ventilated patients. Aust Crit Care. 2017;30(1):37-43. https://doi.org/10.1016/j.aucc.2016.03.004 https://doi.org/10.1016/j.aucc.2016.03.0...
TF < 20-30%4040 Dres M, Dubé BP, Mayaux J, Delemazure J, Reuter D, Brochard L, et al. Coexistence and Impact of Limb Muscle and Diaphragm Weakness at Time of Liberation from Mechanical Ventilation in Medical Intensive Care Unit Patients. Am J Respir Crit Care Med. 2017;195(1):57-66. https://doi.org/10.1164/rccm.201602-0367OC https://doi.org/10.1164/rccm.201602-0367...
,4343 Jung B, Moury PH, Mahul M, de Jong A, Galia F, Prades A, et al. Diaphragmatic dysfunction in patients with ICU-acquired weakness and its impact on extubation failure. Intensive Care Med. 2016;42(5):853-861. https://doi.org/10.1007/s00134-015-4125-2 https://doi.org/10.1007/s00134-015-4125-...
,4646 DiNino E, Gartman EJ, Sethi JM, McCool FD. Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation. Thorax. 2014;69(5):423-427. https://doi.org/10.1136/thoraxjnl-2013-204111 https://doi.org/10.1136/thoraxjnl-2013-2...
,6161 Blumhof S, Wheeler D, Thomas K, McCool FD, Mora J. Change in Diaphragmatic Thickness During the Respiratory Cycle Predicts Extubation Success at Various Levels of Pressure Support Ventilation. Lung. 2016;194(4):519-525. https://doi.org/10.1007/s00408-016-9911-2 https://doi.org/10.1007/s00408-016-9911-...
62 Farghaly S, Hasan AA. Diaphragm ultrasound as a new method to predict extubation outcome in mechanically ventilated patients. Aust Crit Care. 2017;30(1):37-43. https://doi.org/10.1016/j.aucc.2016.03.004 https://doi.org/10.1016/j.aucc.2016.03.0...
-6363 Dres M, Goligher EC, Dubé BP, Morawiec E, Dangers L, Reuter D, et al. Diaphragm function and weaning from mechanical ventilation: an ultrasound and phrenic nerve stimulation clinical study. Ann Intensive Care. 2018;8(1):53. https://doi.org/10.1186/s13613-018-0401-y https://doi.org/10.1186/s13613-018-0401-...
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Diaphragmatic ultrasound and weaning prediction DE < 1 cm and TF < 20-30% associated with increased weaning failure |
Diaphragmatic paralysis |
Main findings |
Potential clinical implications |
1. Chronic paralysis Atrophy: Tdi-exp < 0.11-0.12 cm (LLN)77 Caleffi-Pereira M, Pletsch-Assunção R, Cardenas LZ, Santana PV, Ferreira JG, Iamonti VC, et al. Unilateral diaphragm paralysis: a dysfunction restricted not just to one hemidiaphragm. BMC Pulm Med. 2018;18(1):126. https://doi.org/10.1186/s12890-018-0698-1 https://doi.org/10.1186/s12890-018-0698-...
TF < 20%, even negative2626 Gottesman E, McCool FD. Ultrasound evaluation of the paralyzed diaphragm. Am J Respir Crit Care Med. 1997;155(5):1570-1574. https://doi.org/10.1164/ajrccm.155.5.9154859 https://doi.org/10.1164/ajrccm.155.5.915...
DE absent or weak/paradoxical during QB3434 Boussuges A, Brégeon F, Blanc P, Gil JM, Poirette L. Characteristics of the paralysed diaphragm studied by M-mode ultrasonography. Clin Physiol Funct Imaging. 2019;39(2):143-149. https://doi.org/10.1111/cpf.12549 https://doi.org/10.1111/cpf.12549...
,3535 Lloyd T, Tang YM, Benson MD, King S. Diaphragmatic paralysis: the use of M mode ultrasound for diagnosis in adults. Spinal Cord. 2006;44(8):505-508. https://doi.org/10.1038/sj.sc.3101889 https://doi.org/10.1038/sj.sc.3101889...
DE reduced, absent, or paradoxical during DB and VS3434 Boussuges A, Brégeon F, Blanc P, Gil JM, Poirette L. Characteristics of the paralysed diaphragm studied by M-mode ultrasonography. Clin Physiol Funct Imaging. 2019;39(2):143-149. https://doi.org/10.1111/cpf.12549 https://doi.org/10.1111/cpf.12549...
2. Acute or subacute paralysis Unaltered Tdi-exp (Tdi-exp > 0.15 cm) with abnormal TF (TF < 20% or even negative)3737 Santana PV, Prina E, Caruso P, Carvalho CR, Albuquerque AL. Dyspnea of unknown cause. Think about diaphragm. Ann Am Thorac Soc. 2014;11(10):1656-1659. https://doi.org/10.1513/AnnalsATS.201404-181CC https://doi.org/10.1513/AnnalsATS.201404...
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If diaphragmatic paralysis is suspected: Reduced, absent, or paradoxical DE supports the diagnosis. Reduced Tdi-exp (< 0,11 cm) and reduced TF (< 20%) supports the diagnosis of chronic diaphragmatic paralysis. Reduced, absent, or paradoxical DE and reduced TF < 20% support the diagnosis of acute/subacute diaphragmatic paralysis (Tdi-exp may be unaltered). Diaphragmatic ultrasound may follow the recovery of diaphragmatic paralysis.3838 Summerhill EM, El-Sameed YA, Glidden TJ, McCool FD. Monitoring recovery from diaphragm paralysis with ultrasound. Chest. 2008;133(3):737-743. https://doi.org/10.1378/chest.07-2200 https://doi.org/10.1378/chest.07-2200...
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Cystic fibrosis |
Main findings |
Potential clinical implications |
1. Increased Tdi-exp (effect of training of the diaphragm)6767 Pinet C, Cassart M, Scillia P, Lamotte M, Knoop C, Casimir G, et al. Function and bulk of respiratory and limb muscles in patients with cystic fibrosis. Am J Respir Crit Care Med. 2003;168(8):989-994. https://doi.org/10.1164/rccm.200303-398OC https://doi.org/10.1164/rccm.200303-398O...
,6868 Dufresne V, Knoop C, Van Muylem A, Malfroot A, Lamotte M, Opdekamp C, et al. Effect of systemic inflammation on inspiratory and limb muscle strength and bulk in cystic fibrosis. Am J Respir Crit Care Med. 2009;180(2):153-158. https://doi.org/10.1164/rccm.200802-232OC https://doi.org/10.1164/rccm.200802-232O...
2. Reduced Tdi-exp in severe pulmonary disease and low fat-free mass6969 Enright S, Chatham K, Ionescu AA, Unnithan VB, Shale DJ. The influence of body composition on respiratory muscle, lung function and diaphragm thickness in adults with cystic fibrosis. J Cyst Fibros. 2007;6(6):384-390. https://doi.org/10.1016/j.jcf.2007.02.006 https://doi.org/10.1016/j.jcf.2007.02.00...
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Increased Tdi-exp (due to the effect of training of the diaphragm) or reduced Tdi-exp (due to deleterious effects on respiratory muscle function) |
COPD |
Main findings |
Potential clinical implications |
1. Reduced diaphragmatic mobility,7070 Paulin E, Yamaguti WP, Chammas MC, Shibao S, Stelmach R, Cukier A, et al. Influence of diaphragmatic mobility on exercise tolerance and dyspnea in patients with COPD. Respir Med. 2007;101(10):2113-2118. https://doi.org/10.1016/j.rmed.2007.05.024 https://doi.org/10.1016/j.rmed.2007.05.0...
,7171 Dos Santos Yamaguti WP, Paulin E, Shibao S, Chammas MC, Salge JM, Ribeiro M, et al. Air trapping: The major factor limiting diaphragm mobility in chronic obstructive pulmonary disease patients. Respirology. 2008;13(1):138-144. https://doi.org/10.1111/j.1440-1843.2007.01194.x https://doi.org/10.1111/j.1440-1843.2007...
which was inversely correlated with air trapping7171 Dos Santos Yamaguti WP, Paulin E, Shibao S, Chammas MC, Salge JM, Ribeiro M, et al. Air trapping: The major factor limiting diaphragm mobility in chronic obstructive pulmonary disease patients. Respirology. 2008;13(1):138-144. https://doi.org/10.1111/j.1440-1843.2007.01194.x https://doi.org/10.1111/j.1440-1843.2007...
and dyspnea(70) and positively correlated with 6MWD7070 Paulin E, Yamaguti WP, Chammas MC, Shibao S, Stelmach R, Cukier A, et al. Influence of diaphragmatic mobility on exercise tolerance and dyspnea in patients with COPD. Respir Med. 2007;101(10):2113-2118. https://doi.org/10.1016/j.rmed.2007.05.024 https://doi.org/10.1016/j.rmed.2007.05.0...
2. Tdi-exp and TF similar to controls7272 Baria MR, Shahgholi L, Sorenson EJ, Harper CJ, Lim KG, Strommen JA, et al. B-mode ultrasound assessment of diaphragm structure and function in patients with COPD. Chest. 2014;146(3):680-685. https://doi.org/10.1378/chest.13-2306 https://doi.org/10.1378/chest.13-2306...
3. Tdi-exp and TF inversely correlated with air-trapping7373 Smargiassi A, Inchingolo R, Tagliaboschi L, Di Marco Berardino A, Valente S, Corbo GM. Ultrasonographic assessment of the diaphragm in chronic obstructive pulmonary disease patients: relationships with pulmonary function and the influence of body composition - a pilot study. Respiration. 2014;87(5):364-371. https://doi.org/10.1159/000358564 https://doi.org/10.1159/000358564...
4. During acute exacerbation of COPD: DD (TF < 20%) was associated with poorer outcomes (NIV failure, longer ICU stay, prolonged MV, need for tracheostomy).7474 Antenora F, Fantini R, Iattoni A, Castaniere I, Sdanganelli A, Livrieri F, et al. Prevalence and outcomes of diaphragmatic dysfunction assessed by ultrasound technology during acute exacerbation of COPD: A pilot study. Respirology. 2017;22(2):338-344. https://doi.org/10.1111/resp.12916 https://doi.org/10.1111/resp.12916...
DE predicted NIV failure.(76) |
Air trapping correlated with reduced diaphragmatic mobility, thickness, and thickening. Reduced diaphragmatic mobility correlated with increased dyspnea on exertion. Reduced TF (< 20%) and mobility during acute exacerbation of COPD correlates with poorer outcomes. DE predicted early NIV failure. DE was greater in NIV successes than in NIV failures. |
Interstitial lung diseases |
Main findings |
Potential clinical implications |
1. Reduced DB diaphragmatic mobility correlated with lung function.7878 Santana PV, Prina E, Albuquerque AL, Carvalho CR, Caruso P. Identifying decreased diaphragmatic mobility and diaphragm thickening in interstitial lung disease: the utility of ultrasound imaging. J Bras Pneumol. 2016;42(2):88-94. https://doi.org/10.1590/S1806-37562015000000266 https://doi.org/10.1590/S1806-3756201500...
79 Boccatonda A, Decorato V, Cocco G, Marinari S, Schiavone C. Ultrasound evaluation of diaphragmatic mobility in patients with idiopathic lung fibrosis: a pilot study. Multidiscip Respir Med. 2018;14:1. https://doi.org/10.1186/s40248-018-0159-y https://doi.org/10.1186/s40248-018-0159-...
-8080 Santana PV, Cardenas LZ, de Albuquerque ALP, de Carvalho CRR, Caruso P. Diaphragmatic ultrasound findings correlate with dyspnea, exercise tolerance, health-related quality of life and lung function in patients with fibrotic interstitial lung disease. BMC Pulm Med. 2019;19(1):183. https://doi.org/10.1186/s12890-019-0936-1 https://doi.org/10.1186/s12890-019-0936-...
2. Increased Tdi-exp is an effect of training of the diaphragm.7878 Santana PV, Prina E, Albuquerque AL, Carvalho CR, Caruso P. Identifying decreased diaphragmatic mobility and diaphragm thickening in interstitial lung disease: the utility of ultrasound imaging. J Bras Pneumol. 2016;42(2):88-94. https://doi.org/10.1590/S1806-37562015000000266 https://doi.org/10.1590/S1806-3756201500...
,8080 Santana PV, Cardenas LZ, de Albuquerque ALP, de Carvalho CRR, Caruso P. Diaphragmatic ultrasound findings correlate with dyspnea, exercise tolerance, health-related quality of life and lung function in patients with fibrotic interstitial lung disease. BMC Pulm Med. 2019;19(1):183. https://doi.org/10.1186/s12890-019-0936-1 https://doi.org/10.1186/s12890-019-0936-...
3. Reduced mobility and thickening during DB correlated positively with lung function, exercise tolerance, and HRQoL, correlating negatively with dyspnea.8080 Santana PV, Cardenas LZ, de Albuquerque ALP, de Carvalho CRR, Caruso P. Diaphragmatic ultrasound findings correlate with dyspnea, exercise tolerance, health-related quality of life and lung function in patients with fibrotic interstitial lung disease. BMC Pulm Med. 2019;19(1):183. https://doi.org/10.1186/s12890-019-0936-1 https://doi.org/10.1186/s12890-019-0936-...
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Lung restriction (reduced lung volumes) reduces diaphragmatic mobility and thickening. Maximal diaphragmatic mobility and thickening is associated with clinically relevant parameters (exercise tolerance, HRQoL and dyspnea). |
Neuromuscular disorders |
Main findings |
Potential clinical implications |
1. Reduced Tdi-exp and thickening in patients with ALS with vital capacity < 80% predicted8585 Hiwatani Y, Sakata M, Miwa H. Ultrasonography of the diaphragm in amyotrophic lateral sclerosis: clinical significance in assessment of respiratory functions. Amyotroph Lateral Scler Frontotemporal Degener. 2013;14(2):127-131. https://doi.org/10.3109/17482968.2012.729595 https://doi.org/10.3109/17482968.2012.72...
and in those with bulbar-onset ALS8686 Sartucci F, Pelagatti A, Santin M, Bocci T, Dolciotti C, Bongioanni P. Diaphragm ultrasonography in amyotrophic lateral sclerosis: a diagnostic tool to assess ventilatory dysfunction and disease severity. Neurol Sci. 2019;40(10):2065-2071. https://doi.org/10.1007/s10072-019-03938-9 https://doi.org/10.1007/s10072-019-03938...
2. Thickening with inspiration correlated with SNIP and MEP8484 Pinto S, Alves P, Pimentel B, Swash M, de Carvalho M. Ultrasound for assessment of diaphragm in ALS. Clin Neurophysiol. 2016;127(1):892-897. https://doi.org/10.1016/j.clinph.2015.03.024 https://doi.org/10.1016/j.clinph.2015.03...
and lung function8383 Fantini R, Mandrioli J, Zona S, Antenora F, Iattoni A, Monelli M, et al. Ultrasound assessment of diaphragmatic function in patients with amyotrophic lateral sclerosis. Respirology. 2016;21(5):932-938. https://doi.org/10.1111/resp.12759 https://doi.org/10.1111/resp.12759...
3. Maximal excursion correlated with FVC8787 Carrié C, Bonnardel E, Vally R, Revel P, Marthan R, Marthan R. Vital Capacity Impairment due to Neuromuscular Disease and its Correlation with Diaphragmatic Ultrasound: A Preliminary Study. Ultrasound Med Biol. 2016;42(1):143-149. https://doi.org/10.1016/j.ultrasmedbio.2015.09.020 https://doi.org/10.1016/j.ultrasmedbio.2...
4. The Tdi at VT/Tdi at TLC ratio is indicative of weakness and may predict NIV initiation in ALS8888 Fantini R, Tonelli R, Castaniere I, Tabbì L, Pellegrino MR, Cerri S, et al. Serial ultrasound assessment of diaphragmatic function and clinical outcome in patients with amyotrophic lateral sclerosis. BMC Pulm Med. 2019;19(1):160. https://doi.org/10.1186/s12890-019-0924-5 https://doi.org/10.1186/s12890-019-0924-...
5. Duchenne muscular dystrophy and myotonic dystrophy type 1: Reduced mobility during DB and VS8989 Fayssoil A, Nguyen LS, Ogna A, Stojkovic T, Meng P, Mompoint D, et al. Diaphragm sniff ultrasound: Normal values, relationship with sniff nasal pressure and accuracy for predicting respiratory involvement in patients with neuromuscular disorders. PLoS One. 2019;14(4):e0214288. https://doi.org/10.1371/journal.pone.0214288 https://doi.org/10.1371/journal.pone.021...
DB excursion correlated with FVC values8989 Fayssoil A, Nguyen LS, Ogna A, Stojkovic T, Meng P, Mompoint D, et al. Diaphragm sniff ultrasound: Normal values, relationship with sniff nasal pressure and accuracy for predicting respiratory involvement in patients with neuromuscular disorders. PLoS One. 2019;14(4):e0214288. https://doi.org/10.1371/journal.pone.0214288 https://doi.org/10.1371/journal.pone.021...
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Diaphragm thickness and excursion are reduced and correlate with lung function in ALS. Diaphragm thickening may be related to respiratory muscle strength in ALS. The Tdi at VT/Tdi at TLC ratio may suggest weakness and predict the initiation of NIV in ALS. DB and VS diaphragmatic mobility may be related to SNIP and lung function in Duchenne muscular dystrophy and myotonic dystrophy type 1. |