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Review
. 2020 Apr;46(4):594-605.
doi: 10.1007/s00134-019-05892-8. Epub 2020 Jan 14.

Respiratory muscle ultrasonography: methodology, basic and advanced principles and clinical applications in ICU and ED patients-a narrative review

Pieter R Tuinman  1   2 , Annemijn H Jonkman  1 , Martin Dres  3 , Zhong-Hua Shi  1   4 , Ewan C Goligher  5   6 , Alberto Goffi  5   7 , Chris de Korte  8 , Alexandre Demoule  3 , Leo Heunks  9
Affiliations
Review

Respiratory muscle ultrasonography: methodology, basic and advanced principles and clinical applications in ICU and ED patients-a narrative review

Pieter R Tuinman et al. Intensive Care Med. 2020 Apr.

Abstract

Respiratory muscle ultrasound is used to evaluate the anatomy and function of the respiratory muscle pump. It is a safe, repeatable, accurate, and non-invasive bedside technique that can be successfully applied in different settings, including general intensive care and the emergency department. Mastery of this technique allows the intensivist to rapidly diagnose and assess respiratory muscle dysfunction in critically ill patients and in patients with unexplained dyspnea. Furthermore, it can be used to assess patient-ventilator interaction and weaning failure in critically ill patients. This paper provides an overview of the basic and advanced principles underlying respiratory muscle ultrasound with an emphasis on the diaphragm. We review different ultrasound techniques useful for monitoring of the respiratory muscle pump and possible therapeutic consequences. Ideally, respiratory muscle ultrasound is used in conjunction with other components of critical care ultrasound to obtain a comprehensive evaluation of the critically ill patient. We propose the ABCDE-ultrasound approach, a systematic ultrasound evaluation of the heart, lungs and respiratory muscle pump, in patients with weaning failure.

Keywords: Diaphragm dysfunction; Diaphragm ultrasound; Respiratory muscle ultrasound; Ultrasonography.

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Conflict of interest statement

None of the authors has any conflict to declare.

Figures

Fig. 1
Fig. 1
Clinical application of respiratory muscle ultrasound: techniques and views
Fig. 2
Fig. 2
Point-of-Care Ultrasound (PoCUS) in patients with weaning failure: the ABCDE approach
See this image and copyright information in PMC

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