Fayssoil A, Beaune S, Davido B, Mansencal N. J Clin Ultrasound 2022 Jan. doi: 10.1002/jcu.23074
First lines
The COVID‐19 affects particularly the respiratory system with the onset of pneumonia that can lead to acute respiratory insufficiency. Patients with COVID‐19 pneumonia disclose a hypoxemic respiratory failure associated with an increase of the work of breathing. Ultrasound can be used to evaluate the work of breathing with the analysis of the diaphragm. This technique is particularly used in the context of weaning from mechanical ventilation in Intensive Care Unit (ICU) patients. In critically ill patients, respiratory muscle weakness is associated with an increase of mortality. In the emergency department, diaphragm excursion has been reported to be a prognostic parameter in patients admitted because of a hypercapnic respiratory failure since diaphragm excursion can predict non‐invasive ventilation issue.
SARS‐CoV‐2 viral RNA was found in the diaphragm tissue in post mortem studies and a low diaphragm mass was associated with poorer outcomes in COVID‐19 pneumonia. In addition, diaphragm dysfunction has been reported to predict the onset of invasive mechanical ventilation in COVID‐19 pneumonia and ultrasound diaphragm thickening can predict the response to noninvasive ventilation therapy in COVID‐19 pneumonia. (…)
