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Diagnostic Ultrasound Imaging of Mouse Diaphragm Function

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Published on: April 21, 2014

Diaphragm Thickness and Contraction During Non-Invasive Ventilation: An Ultrasound Study.

Stefano Nobile¹, Annamaria Sbordone¹, Nicola Salce²

¹Neonatal Unit, Fondazione Policlinico Universitario "A. Gemelli", 00168 Rome, Italy.

Children (Basel, Switzerland)

|May 1, 2025

Summary

Diaphragm thickness increased and contractility decreased during non-invasive ventilation (NIV) for neonatal respiratory distress syndrome (RDS). Thicker diaphragms at NIV start and reduced diaphragm function over time were linked to NIV discontinuation failure.

Keywords:

infant lung ultrasound nasal continuous airway pressure non-invasive ventilation work of breathing

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Diaphragmatic Ultrasound in Adults: Image Acquisition and Interpretation

Diaphragmatic Ultrasound in Adults: Image Acquisition and Interpretation

Published on: January 31, 2025

Area of Science:

Neonatology
Pediatric Pulmonology
Medical Ultrasound

Background:

Non-invasive ventilation (NIV) is a cornerstone therapy for neonatal respiratory distress syndrome (RDS).
Limited data exists on diaphragm function, specifically thickness and contractility, during NIV in neonates.
Understanding these changes is crucial for optimizing respiratory support and weaning strategies.

Purpose of the Study:

To characterize changes in diaphragm thickness and contractility during NIV in preterm infants with RDS.
To investigate the association between diaphragm function parameters and failure to discontinue NIV.

Main Methods:

A prospective, single-center study involving diaphragmatic ultrasound assessments weekly during NIV and within 7 days of discontinuation.
Measurement of diaphragm thickness at end-inspiration (DTI) and end-expiration (DTE), and calculation of diaphragm thickening fraction (DTF).
Analysis of clinical data, including NIV discontinuation failure, using univariate and regression models.

Main Results:

Seventeen NIV cycles were analyzed (median duration 21 days).
Diaphragm end-expiratory thickness (DTE) increased, while diaphragm thickening fraction (DTF) decreased over the course of NIV.
NIV discontinuation failure (23.5% of infants) was associated with a thicker diaphragm at NIV initiation and a greater reduction in diaphragm thickness during the NIV cycle.

Conclusions:

Diaphragm thickness increases, and contractility (DTF) decreases over time in preterm infants receiving NIV for RDS.
While NIV duration did not correlate with diaphragm changes, impaired diaphragm function at the start and over the NIV course predicted discontinuation failure.
These findings highlight the importance of monitoring diaphragm function to predict successful NIV weaning in neonates.