ArticleAnnals of intensive care2019
Diaphragm thickening in cardiac surgery: a perioperative prospective ultrasound study.
Article in Annals of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 18 papers.
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 Dysfunction in Cardiac Surgery: Observational Study
Diaphragmatic Inspiratory Amplitude Measured by Ultrasonography as a Prognosticator for Postoperative Pulmonary Complications After Cardiac Surgery: a Prospective Observational Cohort Study
Who cites it
18 citing papers in PubMed.
- A randomized controlled trial of the intraoperative use of noninvasive ventilation versus supplemental oxygen by face mask for procedural sedation in an electrophysiology laboratory.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Trial
- Relationship of Ultrasonically Assessed Diaphragmatic Weakness with the Need for Postoperative Mechanical Ventilation in Older Adult Patients after Major Abdominal Surgeries: An Observational Study.Turkish journal of anaesthesiology and reanimation · 2026Article
- Assessment of Changes in Diaphragm Thickness to Predict Extubation Outcomes After Prolonged Upper Abdominal Surgery.Cureus · 2026Article
- Magnitude and pattern of breathing effort during spontaneous breathing trials after cardiac surgery: a physiological model of sustained breathing effort despite diaphragm dysfunction.Critical care (London, England) · 2026Article
- Maximal inspiratory diaphragmatic ultrasound predicts postoperative pulmonary complications after upper abdominal surgery.Annals of intensive care · 2025Article
- Association of Diaphragmatic Mobility and Thickening Fraction with Postoperative Pulmonary Complications in Patients Undergoing Thoracic Surgery and Their Application in Prediction.Therapeutics and clinical risk management · 2025Article
- Diaphragmatic dysfunction is associated with postoperative pulmonary complications in the aged patients underwent radical resection of esophageal cancer: a prospective observational study.Journal of thoracic disease · 2024Article
- Interest of thoracic ultrasound after cardiac surgery or interventional cardiology.World journal of cardiology · 2024Article
- Diaphragm thickness modifications and associated factors during VA-ECMO for a cardiogenic shock: a cohort study.Annals of intensive care · 2024Article
- Ultrasound assessment of diaphragmatic dysfunction in non-critically ill patients: relevant indicators and update.Frontiers in medicine · 2024Review
- Intraoperative Ventilator Management of the Critically Ill Patient.Anesthesiology clinics · 2023Review
- Persistent diaphragm dysfunction after cardiac surgery is associated with adverse respiratory outcomes: a prospective observational ultrasound study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Observational
- Ultrasonographic Assessment of Diaphragmatic Function and Its Clinical Application in the Management of Patients with Acute Respiratory Failure.Diagnostics (Basel, Switzerland) · 2023Review
- Speckle tracking ultrasonography as a new tool to assess diaphragmatic function: a feasibility study.Ultrasonography (Seoul, Korea) · 2022Article
- Diaphragm Ultrasound in Cardiac Surgery: State of the Art.Medicines (Basel, Switzerland) · 2022Review
- Ultrasound and non-ultrasound imaging techniques in the assessment of diaphragmatic dysfunction.BMC pulmonary medicine · 2021Review
- ICU-acquired weakness, diaphragm dysfunction and long-term outcomes of critically ill patients.Annals of intensive care · 2020Article
- Ultrasonic prediction of weaning failure in children undergoing cardiac surgery: A prospective observational study.Annals of cardiac anaesthesiaObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiaphragm paresis is common after cardiac surgery and may delay the weaning from the ventilator. Our objective was to evaluate diaphragm thickening during weaning and secondly the muscle thickness as a marker of myotrauma.
methodsPatients undergoing elective cardiac surgery were prospectively included. Ultrasonic index of right hemidiaphragm thickening fraction (TF) was measured as a surrogate criterion of work of breathing. A TF < 20% was defined as a low diaphragm thickening. Measurements of TF were performed during three periods to study diaphragm thickening evolution defined by the difference between two consecutive time line point: preoperative (D - 1), during a spontaneous breathing trial (SBT) in the intensive care unit and postoperative (D + 1). We studied three patterns of diaphragm thickness at end expiration evolution from D - 1 to D + 1: > 10% decrease, stability and > 10% increase. Demographical data, length of surgery, type of surgery, ICU length of stay (LOS) and extubation failure were collected.
resultsOf the 100 consecutively included patients, 75 patients had a low diaphragm thickening during SBT. Compared to TF values at D - 1 (36% ± 18), TF was reduced during SBT (17% ± 14) and D + 1 (12% ± 11) (P < 0.0001). Thickness and TF did not change according to the type of surgery or cooling method. TF at SBT was correlated to the length of surgery (both r = - 0.4; P < 0.0001). Diaphragm thickness as continuous variable did not change over time. Twenty-eight patients (42%) had a > 10% decrease thickness, 19 patients (29%) stability and 19 patients (28%) in > 10% increase, and this thickness evolution pattern was associated with: a longer LOS 3 days [2-5] versus 2 days [2-4] and 2 days [2], respectively (ANOVA P = 0.046), and diaphragm thickening evolution (ANOVA P = 0.02). Two patients experience extubation failure.
conclusionThese findings indicate that diaphragm thickening is frequently decreased after elective cardiac surgery without impact on respiratory outcome, whereas an altered thickness pattern was associated with a longer length of stay in the ICU. Contractile activity influenced thickness evolution. Trial registry number ClinicalTrial.gov ID NCT02208479.
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.