Discover and read the best of Twitter Threads about #icisem23
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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)
(1/3)
❌ 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)
(1/3)
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%
(2/3)
❌ 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%
(2/3)
❗️A low TFdi or Pocc predicts diaphragm weakness!
If patient is fully cooperative, try Maximum Inspiratory Pressure (high value excludes muscle weakness).
(3/3)
#ISICEM23
If patient is fully cooperative, try Maximum Inspiratory Pressure (high value excludes muscle weakness).
(3/3)
#ISICEM23
