Ultrasound guided assessment of the diaphragm in predicting success of weaning from mechanical ventilation

Abstract

SUMMARY Introduction The diaphragm is the most important muscle responsible for inspiration. Most patients in intensive care units have some form of diaphragmatic dysfunction that occurs within the first few days of mechanical ventilation. Ventilator-induced diaphragmatic dysfunction is often unrecognized in clinical practice and is associated with difficult weaning from mechanical ventilation. Results Diaphragmatic ultrasound is safe and simple method that can measure the amplitude of motion, thickness, and contraction velocity of the diaphragm. Discussion Diaphragmatic motion amplitude and diaphragmatic thickening fraction can be predictors of successful weaning from mechanical ventilation. Diaphragmatic ultrasound can also be compared with other widely accepted indices of weaning from mechanical ventilation, such as the rapid shallow breathing index. Diaphragmatic ultrasound can also be used to guide diaphragm-protective mechanical ventilation. Conclusion The technique of diaphragmatic ultrasound has its drawbacks; the conducted researches are heterogeneous and there are no clearly defined protocols for ultrasound measurements or reference values for obtained measurement results.