{"title":"如何在重症监护室进行膈肌超声检查","authors":"Greet Hermans, Alexandre Demoule, Leo Heunks","doi":"10.1007/s00134-024-07688-x","DOIUrl":null,"url":null,"abstract":"The diaphragm is a thin, dome-shaped muscle, comprising a costal and crural part, and a non-contracting central tendon. Muscle fiber activation shortens and thickens the diaphragm in the zone of apposition, moving the dome caudally. Diaphragm function, defined as the ability to contract and generate pressure, has substantial reserve capacity. However, clinically significant diaphragm weakness, a marked reduction in its force-generating ability, is an uncommon reason of respiratory failure causing admission to the intensive care unit (ICU). It more commonly develops in critically ill patients, even early during their ICU stay. The pathophysiology hereof remains incompletely understood, with disuse and inflammation recognized as key risk factors [1]. Critical illness-associated diaphragm weakness may complicate weaning and worsen outcomes [2]. Therefore, in specific clinical settings, evaluation of diaphragm function in the ICU is important. Ultrasound allows to noninvasively visualize the diaphragm function and activity at the bedside. In this article, we present our clinical experience with diaphragm ultrasound in daily care.","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"How I perform diaphragmatic ultrasound in the intensive care unit\",\"authors\":\"Greet Hermans, Alexandre Demoule, Leo Heunks\",\"doi\":\"10.1007/s00134-024-07688-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The diaphragm is a thin, dome-shaped muscle, comprising a costal and crural part, and a non-contracting central tendon. Muscle fiber activation shortens and thickens the diaphragm in the zone of apposition, moving the dome caudally. Diaphragm function, defined as the ability to contract and generate pressure, has substantial reserve capacity. However, clinically significant diaphragm weakness, a marked reduction in its force-generating ability, is an uncommon reason of respiratory failure causing admission to the intensive care unit (ICU). It more commonly develops in critically ill patients, even early during their ICU stay. The pathophysiology hereof remains incompletely understood, with disuse and inflammation recognized as key risk factors [1]. Critical illness-associated diaphragm weakness may complicate weaning and worsen outcomes [2]. Therefore, in specific clinical settings, evaluation of diaphragm function in the ICU is important. Ultrasound allows to noninvasively visualize the diaphragm function and activity at the bedside. In this article, we present our clinical experience with diaphragm ultrasound in daily care.\",\"PeriodicalId\":13665,\"journal\":{\"name\":\"Intensive Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":27.1000,\"publicationDate\":\"2024-10-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Intensive Care Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00134-024-07688-x\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Intensive Care Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00134-024-07688-x","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
How I perform diaphragmatic ultrasound in the intensive care unit
The diaphragm is a thin, dome-shaped muscle, comprising a costal and crural part, and a non-contracting central tendon. Muscle fiber activation shortens and thickens the diaphragm in the zone of apposition, moving the dome caudally. Diaphragm function, defined as the ability to contract and generate pressure, has substantial reserve capacity. However, clinically significant diaphragm weakness, a marked reduction in its force-generating ability, is an uncommon reason of respiratory failure causing admission to the intensive care unit (ICU). It more commonly develops in critically ill patients, even early during their ICU stay. The pathophysiology hereof remains incompletely understood, with disuse and inflammation recognized as key risk factors [1]. Critical illness-associated diaphragm weakness may complicate weaning and worsen outcomes [2]. Therefore, in specific clinical settings, evaluation of diaphragm function in the ICU is important. Ultrasound allows to noninvasively visualize the diaphragm function and activity at the bedside. In this article, we present our clinical experience with diaphragm ultrasound in daily care.
期刊介绍:
Intensive Care Medicine is the premier publication platform fostering the communication and exchange of cutting-edge research and ideas within the field of intensive care medicine on a comprehensive scale. Catering to professionals involved in intensive medical care, including intensivists, medical specialists, nurses, and other healthcare professionals, ICM stands as the official journal of The European Society of Intensive Care Medicine. ICM is dedicated to advancing the understanding and practice of intensive care medicine among professionals in Europe and beyond. The journal provides a robust platform for disseminating current research findings and innovative ideas in intensive care medicine. Content published in Intensive Care Medicine encompasses a wide range, including review articles, original research papers, letters, reviews, debates, and more.