Usefulness of Parasternal Intercostal Muscle Ultrasound during Weaning from Mechanical Ventilation

Conclusions Ultrasound assessment of the parasternal intercostal muscle is feasible in the intensive care unit and provides novel information regarding the respiratory capacity load balance.Editor ’s PerspectiveWhat We Already Know about This TopicUltrasound can be used to assess work (i.e., function) and weakness of the diaphragm. This can be helpful in predicting difficulty in weaning patients from mechanical ventilation.Patients who have weakness of the diaphragm may compensate with parasternal muscle activity. However, the feasibility of measuring parasternal intercostal muscle thickening with ultrasound and the ability of these measures to be combined with ultrasound evaluation of the diaphragm in order to predict ability to wean from mechanical ventilation has not been well explored.What This Article Tells Us That Is NewParasternal intercostal muscle thickness can be measured with ultrasound with good interobserver reproducibility.Parasternal intercostal muscle thickening was responsive to the level of ventilator assistance and significantly higher (i.e., increased) in mechanically ventilated patients with diaphragm dysfunction.The pressure-generating capacity of the diaphragm, the diaphragm thickening fraction, and the parasternal intercostal muscle thickening fraction were all significantly associated with failure of a spontaneous breathing trial in mechanically ventilated patients.

Source: Anesthesiology - April 15, 2020 Category: Anesthesiology Source Type: research