• Sigmund J Kharasch, Andrea Loewen, Kevin J Solverson, Tara Lohmann, and MaIrene W YIWY0000-0002-7580-0171Division of General Internal Medicine, Department of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada. ima@ucalgary.ca..
• Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
• Intern Emerg Med. 2024 Dec 13.

AbstractDiaphragmatic dysfunction is an important contributor to hypercapnic respiratory failure, but its presence is often challenging to determine at the bedside. Diaphragm ultrasound provides an opportunity to evaluate the function of the diaphragm noninvasively by evaluating the following parameters that can help define diaphragmatic dysfunction: diaphragm excursion, diaphragm muscle thickness, and thickening fraction. Its evaluation has the potential to assist with diagnosis of respiratory failure, provide prognosis, and assist with patient monitoring and should be considered as part of an internal medicine physician's and emergency physician's skill set. This article provides an overview on how to perform diaphragm ultrasound, review its pitfalls, and discuss the evidence of its use in patients with neuromuscular disorders and chronic obstructive pulmonary disease. Finally, its potential emerging uses in the perioperative setting and for evaluation of acute heart failure are discussed.© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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