• Lucie Fenet Mariani, Jêrome Bedel, Antoine Gros, Nicolas Lerolle, Kolia Milojevic, Virgine Laurent, Julia Hilly, Gilles Troché, Jean Pierre Bedos, and Benjamin Planquette.
• Service de réanimation polyvalente, Versailles-Le Chesnay, France luciefenet84@gmail.com.
• J Intensive Care Med. 2016 Jun 1; 31 (5): 338-43.

PurposeReversibility and impact of diaphragmatic dysfunction (DD) are unknown. The principal aim was to describe diaphragmatic function as assessed by ultrasonography during weaning trials.Materials And MethodsThe present study is a 6-month single-center prospective study. All patients under mechanical ventilation for more than 7 days and eligible for a spontaneous breathing trial (SBT) were enrolled prospectively.InterventionTwo blinded ultrasonographers evaluated each hemidiaphragm during SBT. Prevalence of DD among weaning failure and death and interobserver reproducibility have been evaluated.ResultsThe 34 included patients had a mean Simplified Acute Physiology Score version II of 55.7 ± 14 and a median intensive care unit (ICU) stay length of 17 days (13-30). Diaphragmatic dysfunction was found in 13 (38%) patients, on both sides in 8. Bilateral DD resolved before ICU discharge in 5 of the 7 reevaluated patients. No weaning failures were recorded. The ICU mortality was higher in patients with DD (37% vs 5%, P = .048). Mean interobserver agreement rate was 91%. Reproducibility was better with M-mode.ConclusionThe ICU-acquired DD usually improves before ICU discharge but might constitute a marker for greater disease severity. The present preliminary results require confirmation in a larger prospective multicenter study.© The Author(s) 2015.

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