ArticleCritical care (London, England)2022
EXpert consensus On Diaphragm UltraSonography in the critically ill (EXODUS): a Delphi consensus statement on the measurement of diaphragm ultrasound-derived parameters in a critical care setting.
Article in Critical care (London, England), 2022. 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 101 papers, 7 of them syntheses that pooled it.
What it found
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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.
TESTO-TRIAL: Randomized Clinical Trial on the Use of Testosterone in Critically Ill Patients
Ultrasound Assessment of Diaphragmatic Structure and Function in Patients With Liver Cirrhosis: A Point-of-Care Tool for Predicting Complications and Sarcopenia in Limited Resource Settings
Who cites it
101 citing papers in PubMed, 7 syntheses or guidelines pooled it, 210 citations in OpenAlex.
- Association Between Diaphragm Ultrasound Measures and Extubation Outcomes in Neonates: A Systematic Review and Meta-Analysis.Pediatric pulmonology · 2026Pooled it
- Predictive value of diaphragmatic ultrasound for weaning outcomes in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis.Critical care (London, England) · 2026Pooled it
- Respiratory muscle dysfunction in mechanical ventilation: a systematic review and meta-analysis of biological mechanisms.Journal of applied physiology (Bethesda, Md. : 1985) · 2026Pooled it
- Diaphragmatic Ultrasonography as a Predictor of Extubation Success in Children: Systematic Review and Meta-Analysis.Pediatric pulmonology · 2026Pooled it
- Comparative effects of respiratory stimulants in mechanically ventilated patients: a network meta-analysis of randomized controlled trials.Scientific reports · 2025Pooled it
- Effects of sedatives on diaphragm activity monitored by ultrasound: a systematic review and meta-analysis.BMC anesthesiology · 2025Pooled it
- Accuracy of respiratory muscle assessments to predict weaning outcomes: a systematic review and comparative meta-analysis.Critical care (London, England) · 2024Pooled it
- Effects of rhomboid intercostal and sub-serratus plane block on perioperative analgesic efficacy and diaphragm excursion in video-assisted thoracic surgery: a prospective, randomized controlled trial.BMC anesthesiology · 2025Trial
- Transcutaneous electrical diaphragmatic stimulation in mechanically ventilated patients: a randomised study.Critical care (London, England) · 2023Trial
- Midaxillary-to-midclavicular diaphragmatic mobility ratio predicts weaning success in invasive mechanical ventilation: an observational cohort study.Quantitative imaging in medicine and surgery · 2026Article
- From Opinions to Outcomes: Optimizing Survey Methods and Principles Applicable to the Delphi Process in Critical Care Research.Critical care explorations · 2026Review
- Basic diaphragm ultrasound training: Curriculum implementation and learning trajectory among diaphragm ultrasound naive trainees.World journal of methodology · 2026Article
- Functional Assessment of the Neonatal Diaphragm Using Point-of-Care Ultrasound: A Review of Techniques, Clinical Applications, and Challenges.CHEST pulmonary · 2026Article
- Ultrasound assessment of diaphragmatic structure and function before and after orthotopic liver transplantation in MNGIE.Journal of ultrasound · 2026Article
- Diaphragm ultrasound and surface electromyography as predictors of clinical deterioration in acute exacerbations of COPD: a prospective observational study.ERJ open research · 2026Article
- Rehabilitating the diaphragm: an integrated approach to intensive care unit-acquired dysfunction in critical illness-a narrative review.Acute and critical care · 2026Article
- Combined multi-metric assessment of diaphragm contractile function in healthy humans: Feasibility, validity and reliability.Experimental physiology · 2026Article
- Application of bedside ultrasound assessment of diaphragmatic function in preparing tracheostomised patients for ventilator liberation and decannulation: a narrative review.Journal of thoracic disease · 2026Review
- Influence of Body Position Changes on Diaphragmatic Excursion Assessed by Ultrasonography in a Healthy Population.Journal of functional morphology and kinesiology · 2026Article
- Construction and validation of a risk prediction model for early ventilator-induced diaphragm dysfunction in mechanically ventilated patients.Frontiers in medicine · 2026Article
41 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 14 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiaphragm ultrasonography is rapidly evolving in both critical care and research. Nevertheless, methodologically robust guidelines on its methodology and acquiring expertise do not, or only partially, exist. Therefore, we set out to provide consensus-based statements towards a universal measurement protocol for diaphragm ultrasonography and establish key areas for research.
methodsTo formulate a robust expert consensus statement, between November 2020 and May 2021, a two-round, anonymous and online survey-based Delphi study among experts in the field was performed. Based on the literature review, the following domains were chosen: "Anatomy and physiology", "Transducer Settings", "Ventilator Impact", "Learning and expertise", "Daily practice" and "Future directions". Agreement of ≥ 68% (≥ 10 panelists) was needed to reach consensus on a question.
resultsOf 18 panelists invited, 14 agreed to participate in the survey. After two rounds, the survey included 117 questions of which 42 questions were designed to collect arguments and opinions and 75 questions aimed at reaching consensus. Of these, 46 (61%) consensus was reached. In both rounds, the response rate was 100%. Among others, there was agreement on measuring thickness between the pleura and peritoneum, using > 10% decrease in thickness as cut-off for atrophy and using 40 examinations as minimum training to use diaphragm ultrasonography in clinical practice. In addition, key areas for research were established.
conclusionThis expert consensus statement presents the first set of consensus-based statements on diaphragm ultrasonography methodology. They serve to ensure high-quality and homogenous measurements in daily clinical practice and in research. In addition, important gaps in current knowledge and thereby key areas for research are established. Trial registration The study was pre-registered on the Open Science Framework with registration digital object identifier https://doi.org/10.17605/OSF.IO/HM8UG .
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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.