ArticleAnnals of intensive care2020
The impact of critical illness on the expiratory muscles and the diaphragm assessed by ultrasound in mechanical ventilated children.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Diaphragmatic Ultrasonography as a Predictor of Extubation Success in Children: Systematic Review and Meta-Analysis.Pediatric pulmonology · 2026Pooled it
- Guideline
- Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Document.American journal of respiratory and critical care medicine · 2023Pooled it
- The effect of mechanical ventilation on respiratory muscle echogenicity in critically ill children: an observational cohort study.BMC pediatrics · 2025Observational
- Association of diaphragmatic dysfunction with duration of mechanical ventilation in patients in the pediatric intensive care unit: a prospective cohort study.BMC pediatrics · 2024Article
- Tests and Indices Predicting Extubation Failure in Children: A Systematic Review and Meta-analysis.Pulmonary therapy · 2023Review
- Expiratory Muscles of Respiration and Weaning Failure: What do We Know So Far?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- No association between thickening fraction of the diaphragm and extubation success in ventilated children.Frontiers in pediatrics · 2023Article
- Risk Factors for Physical Function Impairments in Postintensive Care Syndrome: A Scoping Review.Frontiers in pediatrics · 2022Article
- Predictive Value of Diaphragmatic Ultrasonography for the Weaning Outcome in Mechanically Ventilated Children Aged 1-3 Years.Frontiers in pediatrics · 2022Article
- Accessory and Expiratory Muscles Activation During Spontaneous Breathing Trial: A Physiological Study by Surface Electromyography.Frontiers in medicine · 2022Article
- Evolution of inspiratory muscle function in children during mechanical ventilation.Critical care (London, England) · 2021Observational
- Urinary Titin N-Fragment as a Biomarker of Muscle Atrophy, Intensive Care Unit-Acquired Weakness, and Possible Application for Post-Intensive Care Syndrome.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCritical illness has detrimental effects on the diaphragm, but the impact of critical illness on other major muscles of the respiratory pump has been largely neglected. This study aimed to determine the impact of critical illness on the most important muscles of the respiratory muscle pump, especially on the expiratory muscles in children during mechanical ventilation. In addition, the correlation between changes in thickness of the expiratory muscles and the diaphragm was assessed.
methodsThis longitudinal observational cohort study performed at a tertiary pediatric intensive care unit included 34 mechanical ventilated children (> 1 month- < 18 years). Thickness of the diaphragm and expiratory muscles (obliquus interna, obliquus externa, transversus abdominis and rectus abdominis) was assessed daily using ultrasound. Contractile activity was estimated from muscle thickening fraction during the respiratory cycle.
resultsOver the first 4 days, both diaphragm and expiratory muscles thickness decreased (> 10%) in 44% of the children. Diaphragm and expiratory muscle thickness increased (> 10%) in 26% and 20% of the children, respectively. No correlation was found between contractile activity of the muscles and the development of atrophy. Furthermore, no correlation was found between changes in thickness of the diaphragm and the expiratory muscles (P = 0.537). Decrease in expiratory muscle thickness was significantly higher in patients failing extubation compared to successful extubation (- 34% vs - 4%, P = 0.014).
conclusionsChanges in diaphragm and expiratory muscles thickness develop rapidly after the initiation of mechanical ventilation. Changes in thickness of the diaphragm and expiratory muscles were not significantly correlated. These data provide a unique insight in the effects of critical illness on the respiratory muscle pump in children.
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Registered trials
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