Discover and read the best of Twitter Threads about #diaphragm

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A. Demoule: How to assess respiratory muscles strength? #ISICEM23
❌ EMG and p0.1 - they measure drive!
❌ Clinical Examination? - limb muscles ≠ diaphragm strength
- Patient on MV (Pressure Support):
✅ diaphragm ultrasound (TFdi)
✅ measure Pocc (occlusion pressure)
How to perform? #Diaphragm #Ultrasound #ICISEM23
❌ You cannot use if the patient doesn’t trigger the MV
➡️ Intercostal view
➡️ Linear probe
➡️ 8-9 IC space
➡️ Mid axillary line
➡️ 2D then M-Mode
✔️Diaphragm Thickening Fraction: TFdi
✔️ Weaning failure if TFdi < 29%
❗️A low TFdi or Pocc predicts diaphragm weakness!

If patient is fully cooperative, try Maximum Inspiratory Pressure (high value excludes muscle weakness).

Read 3 tweets
#POCUS y #SoMe4MV en #PedsICU
🔊en Ventilación Mecánica 🫁

Abro hilo, iniciamos, y abiertos los comentarios:
Esta información tuvimos el gusto de compartirla en el IV Curso Internacional de Medicina Intensiva Pediátrica dentro del XVI Congreso Internacional de Medicina Intensiva organizado por la @sopemi_org.
Gracias por la invitación. Ahora si, entremos en materia.
Los objetivos planteados en tres puntos:
Relacionar el Ultrasonido Pulmonar (LUS) y la Ventilación Mecánica (VM).
Conocer guías y monitoreo que nos ofrece el POCUS en VM y mencionar elementos evaluables por LUS.
Read 56 tweets

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