Haaksma Mark, Tuinman Pieter Roel, Heunks Leo
Department of Intensive Care Medicine, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands.
Ann Transl Med. 2017 Mar;5(5):114. doi: 10.21037/atm.2017.01.37.
Ultrasound of the diaphragm in critically ill patients has become a diagnostic technique of emerging interest among clinicians and scientists. The advantages include that it is widely available, non-invasive and examination can be performed after relatively short training and at low costs. It is used to estimate muscle mass by measurement of muscle thickness and diagnose weakness by the assessment of diaphragm movement during unassisted breathing. Thickening of the muscle during inspiration has been used to quantify force generation. The enthusiasm that surrounds this topic is shared by many clinicians and we agree that ultrasound is a valuable tool to screen for diaphragm dysfunction in intensive care unit (ICU) patients. However, in our opinion much more studies are required to validate ultrasound as a tool to quantify breathing effort. More sophisticated ultrasound techniques, such as speckle tracking imaging are promising techniques to evaluate respiratory muscle function in patients, including the critically ill.
对重症患者的膈肌进行超声检查已成为临床医生和科学家们日益关注的一种诊断技术。其优点包括广泛可用、无创，且经过相对短期的培训即可进行检查，成本较低。它通过测量肌肉厚度来估计肌肉质量，并通过评估自主呼吸时膈肌的运动来诊断肌无力。吸气时肌肉增厚已被用于量化力量产生。许多临床医生都对这一主题充满热情，我们也认同超声是筛查重症监护病房（ICU）患者膈肌功能障碍的一项有价值的工具。然而，在我们看来，还需要进行更多研究来验证超声作为量化呼吸努力程度工具的有效性。更复杂的超声技术，如散斑追踪成像，是评估患者（包括重症患者）呼吸肌功能的有前景的技术。
