Sonographic evaluation of the diaphragm morphology and function in the critically ill

Diaphragmatic dysfunction is associated with adverse events and outcome. Respiratory insufficiency, hypoxia, prolonged mechanical ventilation, and longer hospital length of stay (1,2) have been reported. Diaphragm disuse and atrophy begins early in mechanically ventilated patients (3). Although the aetiology is poorly defined, myofibril and mitochondrial disruption have been suggested in animal literature (4). Surface ultrasound is a feasible, rapid and a reproducible tool for assessing diaphragmatic function and may be the method of choice for investigating diaphragmatic kinetics (5). But the inability to obtain images in some patients due to anatomical, pathologic, and technical reasons remains a major limitation.