SynthesisIntensive care medicine2017
Assessment of diaphragmatic dysfunction in the critically ill patient with ultrasound: a systematic review.
Synthesis in Intensive care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 8 registered trials, which are not on this map. Cited by 157 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diaphragmatic Rapid Shallow Breathing Index for Predicting Weaning Outcome From Mechanical Ventilation: Comparison With Traditional Rapid Shallow Breathing Index
Evaluation of a 2-hour Educational Programme in Diaphragm Ultrasonographic Assessment
Correlation Between Muscle Thickness and Inflammation With Ventilator Length of Use in Critically Ill Patients: Study on Diaphragm Thickness, Rectus Femoris and Biceps Brachii Cross-sectional Area, and C-reactive Protein Level
Improvement of Weaning From Mechanical Ventilation by Continuous Ultrasound Monitoring of Diaphragm Excursion: the WEAN-US Study
High Flow Oxygen Therapy Through Nasal Cannula in Patients With Acute Respiratory Failure During Bronchoscopy for Bronchoalveolar Lavage
The Effect of 6 ml/kg vs 10 ml/kg Tidal Volume on Diaphragm Dysfunction in Critically Mechanically Ventilated Patient: a Randomized Clinical Trial
The Physiologic Effects of Asymmetrical Versus Conventional High-flow Nasal Cannula in Acute Respiratory Failure. A Randomized Crossover Study.
TESTO-TRIAL: Randomized Clinical Trial on the Use of Testosterone in Critically Ill Patients
Who cites it
157 citing papers in PubMed, 5 syntheses or guidelines pooled it, 395 citations in OpenAlex.
- Diaphragmatic Ultrasonography as a Predictor of Extubation Success in Children: Systematic Review and Meta-Analysis.Pediatric pulmonology · 2026Pooled it
- Weaning from mechanical ventilation in ICU patients: research hotspots and trends in the past decade-a bibliometric analysis.Frontiers in medicine · 2026Pooled it
- Reliability and validity of ultrasonography in evaluating the thickness, excursion, stiffness, and strain rate of respiratory muscles in non-hospitalized individuals: a systematic review.BMC oral health · 2023Pooled it
- Guidance for clinical neurophysiology examination throughout the COVID-19 pandemic. Latin American chapter of the IFCN task force - COVID-19.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2020Guideline
- Pooled it
- Feasibility of the Manual Diaphragm Release Technique in Neurocritical Patients on Mechanical Ventilation: A Pilot Randomized Controlled Trial.Medical sciences (Basel, Switzerland) · 2025Trial
- Effect of liposomal bupivacaine for the suprascapular nerve combined with axillary nerve block on postoperative analgesia in patients undergoing shoulder surgery: a randomized, observer-blinded trial.BMC anesthesiology · 2025Trial
- Effects of external diaphragmatic pacing with neurally adjusted ventilatory assist on diaphragm function in AECOPD patients.Scientific reports · 2025Trial
- Effect of Individualized PEEP Guided by Driving Pressure on Diaphragm Function in Patients Undergoing Laparoscopic Radical Resection of Colorectal Cancer: A Randomized Controlled Trial.Medical science monitor : international medical journal of experimental and clinical research · 2024Trial
- Early rehabilitation relieves diaphragm dysfunction induced by prolonged mechanical ventilation: a randomised control study.BMC pulmonary medicine · 2021Trial
- Neurally adjusted ventilatory assist after surgical treatment of intracerebral hemorrhage: a randomized crossover study.The Journal of international medical research · 2020Trial
- Comparison of standardized diaphragm ultrasound measurement and conventional methods for predicting weaning failure: a prospective observational study.Journal of anesthesia · 2026Observational
- Parasternal intercostal muscle thickening fraction predicts weaning failure in invasively ventilated patients with COPD: a prospective observational study.BMJ open respiratory research · 2026Observational
- Serial Ultrasound Assessment of Diaphragmatic Function in Term Neonates During the First 48 Hours of Life.Diagnostics (Basel, Switzerland) · 2026Article
- Review
- Article
- The effect of upper transabdominal plane block on diaphragm thickness in adult patients after laparoscopic cholecystectomy operation.Journal of minimal access surgery · 2026Article
- Basic diaphragm ultrasound training: Curriculum implementation and learning trajectory among diaphragm ultrasound naive trainees.World journal of methodology · 2026Article
- Are right-sided diaphragmatic parameters sufficient to accurately evaluate global diaphragmatic physiological function? Commentary on "diaphragm physiological similarity index (DPSI): a de novo speckle-tracking ultrasound metric for HFNC adjustment in acute respiratory failure".Critical care (London, England) · 2026Article
- Ultrasound assessment of diaphragmatic structure and function before and after orthotopic liver transplantation in MNGIE.Journal of ultrasound · 2026Article
97 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDiaphragmatic dysfunction (DD) has a high incidence in critically ill patients and is an under-recognized cause of respiratory failure and prolonged weaning from mechanical ventilation. Among different methods to assess diaphragmatic function, diaphragm ultrasonography (DU) is noninvasive, rapid, and easy to perform at the bedside. We systematically reviewed the current literature assessing the usefulness and accuracy of DU in intensive care unit (ICU) patients.
methodsPubmed, Cochrane Database of Systematic Reviews, Embase, Scopus, and Google Scholar Databases were searched for pertinent studies. We included all original, peer-reviewed studies about the use of DU in ICU patients.
resultsTwenty studies including 875 patients were included in the final analysis. DU was performed with different techniques to measure diaphragmatic inspiratory excursion, thickness of diaphragm (Tdi), and thickening fraction (TF). DU is feasible, highly reproducible, and allows one to detect diaphragmatic dysfunction in critically ill patients. During weaning from mechanical ventilation and spontaneous breathing trials, both diaphragmatic excursion and diaphragmatic thickening measurements have been used to predict extubation success or failure. Optimal cutoffs ranged from 10 to 14 mm for excursion and 30-36 % for thickening fraction. During assisted mechanical ventilation, diaphragmatic thickening has been found to be an accurate index of respiratory muscles workload. Observational studies suggest DU as a reliable method to assess diaphragm atrophy in patients undergoing mechanical ventilation.
conclusionsCurrent literature suggests that DU could be a useful and accurate tool to detect diaphragmatic dysfunction in critically ill patients, to predict extubation success or failure, to monitor respiratory workload, and to assess atrophy in patients who are mechanically ventilated.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.