Measuring abdominal muscle function by abdominal muscle thickening on ultrasound: reproducibility, validity and normal range values

Schreiber, Annia; Sabatini, Umberto; Vorona, Stefannie; Bertoni, Michele; Piva, Simone; Goligher, Ewan C.

doi:10.1183/13993003.congress-2019.oa5367

Cited by 2 publications

(3 citation statements)

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“…Thickening fraction of the expiratory abdominal muscles (TFabd) can be calculated as the magnitude of thickness increase during expiration (TFadb = (end-expiratory thickness − end-inspiratory thickness)/end-inspiratory thickness) × 100%) and may reflect expiratory muscle effort. Preliminary data seem to demonstrate reasonable correlation between TFabd and expiratory force generation [29]. It should be noted that expiratory muscles have more degrees of freedom compared to the diaphragm; active contraction of one muscle layer may directly affect the shortening and position of the adjacent layer, which may make interpretation of TFabd more complex.…”

Section: Abdominal Wall Expiratory Musclesmentioning

confidence: 85%

Respiratory muscle ultrasonography: methodology, basic and advanced principles and clinical applications in ICU and ED patients—a narrative review

et al. 2020

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Respiratory muscle ultrasound is used to evaluate the anatomy and function of the respiratory muscle pump. It is a safe, repeatable, accurate, and non-invasive bedside technique that can be successfully applied in different settings, including general intensive care and the emergency department. Mastery of this technique allows the intensivist to rapidly diagnose and assess respiratory muscle dysfunction in critically ill patients and in patients with unexplained dyspnea. Furthermore, it can be used to assess patient-ventilator interaction and weaning failure in critically ill patients. This paper provides an overview of the basic and advanced principles underlying respiratory muscle ultrasound with an emphasis on the diaphragm. We review different ultrasound techniques useful for monitoring of the respiratory muscle pump and possible therapeutic consequences. Ideally, respiratory muscle ultrasound is used in conjunction with other components of critical care ultrasound to obtain a comprehensive evaluation of the critically ill patient. We propose the ABCDE-ultrasound approach, a systematic ultrasound evaluation of the heart, lungs and respiratory muscle pump, in patients with weaning failure.

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Section: Abdominal Wall Expiratory Musclesmentioning

confidence: 85%

Respiratory muscle ultrasonography: methodology, basic and advanced principles and clinical applications in ICU and ED patients—a narrative review

et al. 2020

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Section: Methodsmentioning

confidence: 99%

“…TF IO was calculated as the magnitude of thickness increased during coughing with maximum strength (TF IO = [end-coughing thickness − end-inspiratory thickness]/[end-inspiratory thickness] × 100%). 17,24 Diaphragmatic ultrasound was performed during maximum sniff breathing with a C5-1s convex transducer positioned below the right costal arch at the midclavicular line by angling the ultrasound beam cranially and perpendicular to the diaphragmatic dome. 25 B-mode was initially used to visualize the diaphragm as an echogenic line between the interface of the lung and liver and was then changed to M-mode to measure DIA on the vertical axis, tracing from the baseline to the point of a maximum height of inspiration on the graph.…”

Section: Anesthesia and Analgesiamentioning

confidence: 99%

Sugammadex Versus Neostigmine for Recovery of Respiratory Muscle Strength Measured by Ultrasonography in the Postextubation Period: A Randomized Controlled Trial

Huang

Wang

et al. 2022

Anesthesia &Amp; Analgesia

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BACKGROUND: Although sugammadex is well known for its use in reducing the incidence of residual neuromuscular blockade, this has not always been translated to improved clinical measures of postoperative respiratory muscle strength. Expiratory muscles play an important role in airway clearance and inspiratory muscle capacity augmentation, yet they have not been well studied. Therefore, we tested the hypothesis on whether sugammadex could enhance expiratory muscle strength recovery more completely than neostigmine in the immediate postextubation period. METHODS: Adult patients having microlaryngeal surgery under total intravenous anesthesia were randomized to receive sugammadex or neostigmine. The thickening fraction of internal oblique abdominal muscle (TF IO ) and diaphragm excursion, respectively, reflecting expiratory and inspiratory muscle strength, were measured via ultrasonography at 3 time points: before induction (baseline), train-of-four ratio (TOFR) recovery to 0.9, and 30 minutes after postanesthesia care unit (PACU) arrival. The primary outcome was the change in TF IO from baseline to TOFR ≥0.9. The postoperative changes of diaphragm excursion from baseline, incidences of TF IO and diaphragm excursion returning to baseline levels, and the time from TOFR 0.9 to 0.95 and 1 were also measured. RESULTS: Among 58 patients, a significant difference in the change in TF IO from baseline to TOFR ≥0.9 between the sugammadex and neostigmine groups was observed: mean ± standard deviation, 9% ± 6% vs 16% ± 9%; difference in means: −6% (95% confidence interval [CI], −10 to −2); and adjusted P =.005 (adjusting for imbalanced variables between 2 groups). Sugammadex resulted in smaller changes in diaphragm excursion from baseline to TOFR ≥0.9 compared with neostigmine: difference in means: −0.83 cm (99.4% CI, −1.39 to −0.28 cm; Bonferroni-corrected P < .001). After 30 minutes in the postanesthesia care unit (PACU),33% of patients reversed with sugammadex versus 14% of those receiving neostigmine reached baseline TF IO levels (99.4% CI, −14 to 52; Bonferroni-corrected P > .999). The incidences of TF IO and diaphragm excursion returning to baseline were relatively low (<40%) in both groups despite TOFR reaching 1. The median time from TOFR of 0.9 to 0.95 and to 1 among patients receiving sugammadex was 7 and 10× faster than those receiving neostigmine (0.3 vs 2 minutes, Bonferroni-corrected P = .003; 0.5 vs 5.3 minutes, Bonferroni-corrected P < .001, respectively). CONCLUSIONS: Sugammadex provides a more complete recovery of expiratory muscle strength than neostigmine at TOFR ≥0.9. Our data suggest that the respiratory muscle streng...

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Measuring abdominal muscle function by abdominal muscle thickening on ultrasound: reproducibility, validity and normal range values

Cited by 2 publications

References 0 publications

Respiratory muscle ultrasonography: methodology, basic and advanced principles and clinical applications in ICU and ED patients—a narrative review

Respiratory muscle ultrasonography: methodology, basic and advanced principles and clinical applications in ICU and ED patients—a narrative review

Sugammadex Versus Neostigmine for Recovery of Respiratory Muscle Strength Measured by Ultrasonography in the Postextubation Period: A Randomized Controlled Trial

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