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.

中文翻译：

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我如何在重症监护病房进行膈肌超声检查


横膈膜是一块薄的圆顶状肌肉，由肋部和脚部以及非收缩的中央肌腱组成。肌纤维激活使并置区的横膈膜缩短和增厚，使圆顶尾部移动。隔膜功能，定义为收缩和产生压力的能力，具有相当大的储备能力。然而，有临床意义的膈肌无力，即其发力能力的显着降低，是导致呼吸衰竭进入重症监护病房 （ICU） 的不常见原因。它更常见于危重患者，甚至在 ICU 住院早期。其病理生理学仍不完全清楚，废弃和炎症被认为是关键的危险因素 [1]。危重疾病相关的膈肌无力可能会使脱机复杂化并恶化结局 [2]。因此，在特定的临床环境中，评估 ICU 中的膈肌功能很重要。超声波可以在床边无创地观察隔膜的功能和活动。在本文中，我们介绍了我们在日常护理中使用隔膜超声的临床经验。