Intensive Care Unit, Papageorgiou General Hospital, Thessaloniki, Greece.
Intensive Care Med. 2013 May;39(5):801-10. doi: 10.1007/s00134-013-2823-1. Epub 2013 Jan 24.
The use of ultrasonography has become increasingly popular in the everyday management of critically ill patients. It has been demonstrated to be a safe and handy bedside tool that allows rapid hemodynamic assessment and visualization of the thoracic, abdominal and major vessels structures. More recently, M-mode ultrasonography has been used in the assessment of diaphragm kinetics. Ultrasounds provide a simple, non-invasive method of quantifying diaphragmatic movement in a variety of normal and pathological conditions. Ultrasonography can assess the characteristics of diaphragmatic movement such as amplitude, force and velocity of contraction, special patterns of motion and changes in diaphragmatic thickness during inspiration. These sonographic diaphragmatic parameters can provide valuable information in the assessment and follow up of patients with diaphragmatic weakness or paralysis, in terms of patient-ventilator interactions during controlled or assisted modalities of mechanical ventilation, and can potentially help to understand post-operative pulmonary dysfunction or weaning failure from mechanical ventilation. This article reviews the technique and the clinical applications of ultrasonography in the evaluation of diaphragmatic function in ICU patients.
超声检查在危重症患者的日常管理中越来越受欢迎。它已被证明是一种安全、便捷的床边工具，可快速进行血流动力学评估，并可对胸部、腹部和大血管结构进行可视化检查。最近，M 型超声检查已用于评估膈肌动力学。超声检查提供了一种简单、无创的方法，可在各种正常和病理情况下定量评估膈肌运动。超声检查可以评估膈肌运动的特征，如振幅、收缩力和速度、特殊的运动模式以及吸气时膈肌厚度的变化。这些超声膈肌参数可在评估和随访膈肌无力或瘫痪患者时提供有价值的信息，包括在控制或辅助机械通气模式下患者与呼吸机的相互作用，并且可能有助于理解术后肺部功能障碍或从机械通气中脱机失败。本文综述了超声检查技术及其在 ICU 患者膈肌功能评估中的临床应用。
