Body Position Affects Ultrasonographic Measurement of Diaphragm Contractility.
Christopher Brown, Shih-Chiao Tseng, Katy Mitchell and 1 others
PMID 30319315WHAT IT FOUND
Diaphragm ultrasound measurements changed significantly when healthy young adults moved from lying down to sitting and standing.
A physical therapist with minimal training achieved excellent reliability. However, this study only tested healthy people, so it does not yet show how position affects diaphragm function in ICU patients.
Key findings
01Diaphragm thickening fraction was significantly different across supine, seated, and standing positions in healthy participants.
02Intrarater reliability for ultrasound measurements was excellent (0.93 to 0.98) across all positions when performed by a novice physical therapist.
03The study population consisted exclusively of healthy graduate students, limiting direct application to clinical populations.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The participants were all healthy graduate students, not patients. Obese individuals (BMI > 30) were excluded, so the method's feasibility in this common ICU population is unknown. Only one operator performed the measurements, so reproducibility across different therapists was not tested. The study did not include patients on mechanical ventilation or those with respiratory disease.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not apply these position-dependent diaphragm contractility values to your ICU patients. The study was conducted on healthy young adults who could stand freely, and the authors explicitly state that the results need to be replicated in critically ill patients before clinical significance can be ascribed.