ArticleEuropean journal of pediatrics2025
Diaphragmatic ultrasonography: reference values and reliability for thickness, thickening fraction, and excursion in neonates.
Article in European journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Comparison of diaphragmatic thickness fraction between prone and supine positioning in preterm and sick term neonates: a prospective study.European journal of pediatrics · 2026Observational
- Serial Ultrasound Assessment of Diaphragmatic Function in Term Neonates During the First 48 Hours of Life.Diagnostics (Basel, Switzerland) · 2026Article
- Diaphragm ultrasound and lung aeration in small-for-gestational-age versus appropriate-for-gestational-age newborns: a cross-sectional study.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Combined diaphragm and lung ultrasound profiling in healthy full-term neonates: a study of early postnatal function.European journal of pediatrics · 2026Observational
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4 authors.
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Abstract
To establish reference values and assess the intra- and inter-rater reliability of inspiratory diaphragmatic thickness (IDT), expiratory diaphragmatic thickness (EDT), diaphragmatic thickening fraction (DTF), and diaphragmatic excursion (DE) using ultrasound, including the lower (LLN) and upper (ULN) limits of normality in neonates. This cross-sectional study included healthy neonates from a public hospital (July 2022-December 2023). IDT, EDT, DTF, and DE were measured by PT 1 (an experienced ultrasound physiotherapist). Reliability was assessed by having PT 1 and PT 2 (experts ultrasound physiotherapists) independently evaluate the exams twice using ImageJ software. Intraclass correlation coefficients (ICC) with 95% confidence intervals (CI) were calculated to assess intra- and inter-rater reliability. One hundred neonates were assessed [39 (38-40) weeks, 3168 ± 475 g, 49 (47.5-50) cm]. Reference values were EDT: 2.17 ± 0.59 mm, LLN: 2.05 mm and ULN: 2.29 mm; IDT: 1.71 ± 0.48 mm, LLN: 1.62 mm and ULN: 1.80 mm; DTF: 28.02 ± 9.88%, LLN: 26.08% and ULN: 29.96%; DE: 2.47 ± 0.72 mm, LLN: 2.33 mm and ULN: 2.61 mm. No significant differences were observed between the assessments of PT 1 and PT 2 (p > 0.05), intra- and inter-rater reliability were ICC ≥ 0.98 (0.97-1.00) (p < 0.001) and ICC ≥ 0.91 (0.85-0.99) (p < 0.001), respectively.
conclusionThe established values support interpreting neonatal diaphragmatic function and detecting changes in contractility and motion range, with high intra- and inter-rater reliability for EDT, IDT, DTF, and DE. WHAT IS KNOWN: • Diaphragmatic ultrasound is used to assess diaphragm function in various clinical contexts; however, its reliability and reference values for neonates are limited. WHAT IS NEW: • Performing diaphragmatic ultrasound in neonates requires specific precautions to obtain accurate and reliable measurements. • The established normal, lower, and upper limits for diaphragmatic thickness and excursion support the functional assessment of the diaphragm in neonates by aiding in the detection of changes in contractility and movement, providing valuable reference values for clinical decision-making.
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