Observational studyBMC pulmonary medicine2022
Increased diaphragm echodensity correlates with postoperative pulmonary complications in patients after major abdominal surgery: a prospective observational study.
Observational study in BMC pulmonary medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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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
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Who cites it
7 citing papers in PubMed, 15 citations in OpenAlex.
- Impact of Sugammadex versus Neostigmine on Diaphragmatic Function and Respiratory Recovery in Morbidly Obese Patients with Moderate Neuromuscular Block: A Randomised Double-Blind Controlled Trial.Drug design, development and therapy · 2026Trial
- Ultrasound innovations in diaphragm assessment: an integrative review of expanding clinical applications.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Article
- 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
- Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report.BMC infectious diseases · 2024Article
- Perioperative predictive factors of failure to rescue following highly advanced hepatobiliary-pancreatic surgery: a single-institution retrospective study.World journal of surgical oncology · 2023Article
- Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram.Frontiers in surgery · 2023Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAssociated with increased morbidity and mortality, postoperative pulmonary complications (PPCs) often occur after major abdominal surgery. Diaphragmatic dysfunction is suggested to play an important role in the development of PPCs and diaphragm echodensity can be used as an indicator of diaphragm function. This study aimed to determine whether diaphragm echodensity could predict the occurrence of PPCs in patients after major abdominal surgery.
methodsDiaphragm ultrasound images of patients after major abdominal surgery were collected during spontaneous breathing trials. Echodensity was quantified based on the right-skewed distribution of grayscale values (50th percentile, ED50; 85th percentile, ED85; mean, EDmean). Intra- and inter-analyzer measurement reproducibility was determined. Outcomes including occurrence of PPCs, reintubation rate, duration of ventilation, and length of ICU stay were recorded.
resultsDiaphragm echodensity was measured serially in 117 patients. Patients who developed PPCs exhibited a higher ED50 (35.00 vs. 26.00, p < 0.001), higher ED85 (64.00 vs. 55.00, p < 0.001) and higher EDmean (39.32 vs. 33.98, p < 0.001). In ROC curve analysis, the area under the curve of ED50 for predicting PPCs was 0.611. The optimal ED50 cutoff value for predicting the occurrence of PPCs was 36. According to this optimal ED50 cutoff value, patients were further divided into a high-risk group (ED50 > 36, n = 35) and low-risk group (ED50 ≤ 36, n = 82). Compared with the low-risk group, the high-risk group had a higher incidence of PPCs (unadjusted p = 0.003; multivariate-adjusted p < 0.001).
conclusionDiaphragm echodensity can be feasibly and reproducibly measured in mechanically ventilated patients. The increase in diaphragm echodensity during spontaneous breathing trials was related to an increased risk of PPCs in patients after major abdominal surgery.
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