Unit of Pulmonology and Respiratory Pathophysiology, Clinic of Medical Sciences, Aorn Sant'Anna and San Sebastiano Hospital, Caserta, Italy.
Unit of Pulmonology, Department of Biomedical and Dental Sciences, Messina University Faculty of Medicine, Messina, Italy.
Tuberk Toraks. 2023 Mar;71(1):7-12. doi: 10.5578/tt.20239902.
Over the past few years, there has been an increase in lung and diaphragm ultrasound applications as a tool to evaluate the outcomes and settings of noninvasive respiratory supports. However, actual clinical practices in this field are yet to be known. The aim of this study was to investigate the current clinical utilization of ultrasound for noninvasive respiratory supports on an international level.
The study employed an online survey consisting of 32 items, which was sent via email to intensivists, pulmonologists, emergency medicine physicians, and other specialists with expertise in using ultrasound and/or noninvasive respiratory supports.
We collected 52 questionnaires. The ultrasound study of diaphragm dysfunction was well-known by the majority of respondents (57.7%). Diaphragm performance was used as a weaning failure predictor (48.5%), as a predictor of noninvasive ventilation failure (38.5%) and as a tool for the ventilator settings adjustment (30.8%). In patients with acute respiratory failure, 48.1% used ultrasound to assess the damaged lung area to set up ventilatory parameters, 34.6% to monitor it after noninvasive ventilation application, and 32.7% to match it with the ventilatory settings for adjustment purposes. When administering high flow nasal cannula - oxygen therapy, 42.3% of participants used ultrasound to evaluate lung involvement and assess flow parameters.
Lung and diaphragm ultrasound is an established clinical practice to evaluate noninvasive respiratory supports outcomes and settings. Further studies are needed to evaluate the educational aspects to increase confidence and indications for its use.
在过去的几年中，肺部和膈肌超声应用作为评估无创呼吸支持的结果和设置的工具有所增加。然而，该领域的实际临床实践仍有待了解。本研究旨在调查国际上无创呼吸支持中超声的当前临床应用情况。
本研究采用了一项包含 32 个项目的在线调查，通过电子邮件发送给重症监护医生、肺科医生、急诊医学医生和其他具有超声和/或无创呼吸支持使用专业知识的专家。
我们共收集了 52 份问卷。膈肌功能障碍的超声研究被大多数受访者（57.7%）所熟知。膈肌功能被用作脱机失败的预测指标（48.5%），无创通气失败的预测指标（38.5%）和呼吸机参数调整的工具（30.8%）。在急性呼吸衰竭患者中，48.1%的人使用超声来评估受损的肺区以设置通气参数，34.6%的人在应用无创通气后监测它，32.7%的人将其与呼吸机参数匹配以进行调整。在给予高流量鼻导管 - 氧疗时，42.3%的参与者使用超声评估肺受累情况并评估流量参数。
肺部和膈肌超声是评估无创呼吸支持的结果和设置的既定临床实践。需要进一步研究评估教育方面，以提高对其使用的信心和适应症。
