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Introduction Muscle monitoring during mechanical ventilation (MV) is gaining great interest nowadays; however, a proper monitoring tool is not well‐established yet. Objectives To assess the role of ultrasound in muscle monitoring during MV in respiratory patients. Methods Eligible 68 mechanically ventilated patients were consecutively enrolled. Serial ultrasound measurements of diaphragmatic thickness at the end of inspiration (Tdi) and mid‐upper arm (MUA) muscle thickness were recorded every other day till weaning. Before discharge, functional status score (FSS) was assessed. Results Tdi decreased in 72.1%, did not change in 13.2% and increased in 14.7% of the patients. MUA muscle thickness decreased in 47.17% and did not change in others. Significant correlation between Tdi and MUA muscle thickness change was found (r = 0.404, P = 0.001); however, MUA muscle thickness change could not predict Tdi change (B = 0.067, P = 0.059). Diaphragmatic and MUA thickness change showed significant negative correlation with ICU stay (r = −0.260, −0.647, P = 0.032, <0.001) and MV duration (r = −0.335, −0.596, P = 0.005, <0.001), respectively. Weaning failure was significantly higher among patients with decreased Tdi (64.28%) and FSS was significantly lower in those with decreased MUA muscle thickness. US measurements of Tdi and MUA muscle thickness showed excellent intra‐observer (ICC = 0.996, 0.999, P < 0.001) and inter‐observer agreement (ICC = 0.992, 0.998, P < 0.001), respectively. Conclusion Sonographic muscle monitoring during MV is promising. Changes in the diaphragmatic thickness during MV are common and weakly related to those of peripheral muscles. Early decreased muscle thickness heralds poor weaning and functional outcome.

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Background Lung cancer incidence has greatly increased over the past century. Moreover, the lung is the most common site of metastatic involvement. Despite improvements in the diagnosis and treatment of lung malignancies, patient prognosis is still unsatisfactory. Locoregional chemotherapeutic techniques for the treatment of lung malignancies are the current focus of research. The aim of this review article is to present different locoregional intravascular techniques and their treatment principles and to assess the pros and cons of each of them as a palliative and neoadjuvant treatment method in the treatment of lung malignancy. Method The different methods for the treatment of malignant lung lesions such as isolated lung perfusion (ILP), selective pulmonary artery perfusion (SPAP), transpulmonary chemoembolization (TPCE), bronchial artery infusion (BAI), bronchioarterial chemoembolization (BACE), and intraarteriel chemoperfusion (IACP) are evaluated comparatively. Results Locoregional intravascular chemotherapy procedures are proving to be promising treatment options in the management of malignant lung tumors. In order to achieve optimal results, the locoregional technique should be used to achieve the highest possible uptake of the chemotherapeutic agent into the target tissue with rapid systemic clearance. Conclusion Among the various treatment options for lung malignancies, TPCE is the best evaluated treatment concept. However, further studies are necessary to define the optimal treatment concept with the best clinical outcomes. Key Points  Citation Format

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