Observational studyCritical care (London, England)2025
Diaphragmatic ultrasound and its relationship to breathing effort and load: a prospective observational study.
Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Integrated comprehensive assessment for predicting weaning success in difficult-to-wean critically ill patients: the WEAN-US study.Critical care (London, England) · 2026Observational
- Intercostal thickening fraction adds no value to diaphragm thickening fraction in healthy subjects undergoing noninvasive ventilation.Scientific reports · 2026Article
- Patient Self-Inflicted Lung Injury in ARDS: From Physiological Concept to Clinical Syndrome.Journal of clinical medicine · 2026Review
- Ventilator-induced lung injury: from mechanisms to integrated clinical management.Frontiers in medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFailure to wean from invasive mechanical ventilation is multifactorial, with diaphragmatic dysfunction a significant contributing factor. Diaphragmatic function can be easily and non-invasively assessed by ultrasound. However, it remains unknown how ultrasound measurements of diaphragm function are affected by changes in apparent work of breathing.
methodsIn patients undergoing weaning from mechanical ventilation, we evaluated diaphragmatic ultrasound measurements [diaphragmatic excursion (Dex), diaphragmatic thickening fraction (Tfdi)] simultaneously with manometric indices of breathing effort and load [esophageal pressure swings (ΔPes), transdiaphragmatic pressure swings (ΔPdi), and the pressure-time product of esophageal pressure (PTPes)]. These assessments were performed during two distinct phases; during an unassisted spontaneous breathing trial (phase SBT) and during an inspiratory resistive loading with 30 cmH
resultsForty-nine patients were enrolled. Dex correlated with ΔPes (r = 0.5, p < 0.001), ΔPdi (r = 0.55, p = < 0.001) and PTPes (r = 0.32, p = 0.031). Tfdi did not correlate with ΔPes (r = 0.27, p = 0.052), ΔPdi (r = 0.2, p = 0.235) and PTPes (r = 0.24, p = 0.110). Dex and Tfdi increased during IRL compared to SBT [1.44(0.89-1.96) vs. 1.05(0.7-1.59), p = 0.002], [0.55(± 0.32) vs 0.46(± 0.2), p = 0.019] as did Pes, Pdi and PTPes [(11.87 (7.86, 18.32) vs. 6.8 (4.6-10.23), p < 0.001), (10.89 (± 6.42) vs. 7.94 (± 3.81), p < 0.001), and (181.10 (108.34, 311.7) vs. 97.52 (55.96-179.87), p < 0.001), respectively].
conclusionIn critical care patients spontaneously breathing under resistive load, diaphragmatic excursion had a weak to moderate correlation with indices of breathing effort and differed between weaning success and failure.
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