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Acute respiratory failure (ARF) is a common life-threatening medical condition, with multiple underlying etiologies. In these cases, many factors related to systemic inflammation, prolonged use of steroids, and lung mechanical abnormalities (such as hyperinflation or increased elastic recoil due to pulmonary oedema or fibrosis) may act as synergic mechanisms leading to diaphragm dysfunction. The assessment of diaphragm function with ultrasound has been increasingly investigated in the emergency department and during hospital stay as a valuable tool for providing additional anatomical and functional information in many acute respiratory diseases. The diaphragmatic ultrasound is a noninvasive and repeatable bedside tool, has no contraindications, and allows the physician to rapidly assess the presence of diaphragmatic dysfunction; this evaluation may help in estimating the need for mechanical ventilation (and the risk of weaning failure), as well as the risk of longer hospital stay and higher mortality rate. This study presents an overview of the recent evidence regarding the evaluation of diaphragmatic function with bedside ultrasound and its clinical applications, including a discussion of real-life clinical cases.
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http://dx.doi.org/10.3390/diagnostics13030411 | DOI Listing |
Thorax
September 2025
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Introduction: Breathlessness is a common cause of hospital admission globally and is associated with high mortality, particularly in low-income countries. In sub-Saharan Africa, there is a paucity of data on breathlessness, with existing data focused on individual diseases. There is a need for patient-centred approaches to understand interactions between multiple conditions to address population needs and inform health system responses.
View Article and Find Full Text PDFInt Heart J
September 2025
Second Department of Internal Medicine, University of Toyama.
A novel telemonitoring system utilizing contactless sensor technologies combined with automated overnight respiratory stability time (RST) analysis has emerged as a sensitive and specific indicator of worsening heart failure (HF), enabling early clinical exacerbation identification. However, the correlation between the RST trajectory and other clinical parameters, as well as targeted therapeutic strategies for improving RST in patients experiencing acute decompensated HF, remains unclear. Herein, we present two cases of hospitalized patients with HF and reduced left ventricular ejection fraction, which were successfully managed through clinical interventions monitored by integrated RST parameters.
View Article and Find Full Text PDFRespir Care
September 2025
Dr. Thomasian and Prof. Wunsch are affiliated with Department of Anesthesiology, Weill Cornell Medicine, New York, New York, USA.
Negative-pressure ventilation (NPV) is a form of noninvasive respiratory support in which an external subatmospheric pressure is applied to the thorax to facilitate lung expansion. Although largely supplanted by positive-pressure ventilation (PPV) in modern-day practice, NPV has garnered renewed interest as a potential noninvasive adjunct or alternative to PPV. Appropriate patient selection would be key, particularly in the ICU setting, where NPV is generally contraindicated in patients with severe upper airway obstruction, high oxygenation requirements, or absent airway reflexes.
View Article and Find Full Text PDFBMJ Open
September 2025
Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Introduction: Nipah virus (NiV) is a bat-transmitted paramyxovirus causing recurrent, high-mortality outbreaks in South and South-East Asia. As a WHO priority pathogen, efforts are underway to develop therapies like monoclonal antibodies and small-molecule antivirals, which require evaluation in clinical trials. However, trial design is challenging due to limited understanding of NiV's clinical characteristics.
View Article and Find Full Text PDFRespir Physiol Neurobiol
September 2025
Department of Pediatrics, School of Medicine, Duke University.
Pompe disease is an autosomal recessive neuromuscular disorder characterized by a deficiency of acid α-glucosidase (GAA), an enzyme responsible for lysosomal glycogen degradation in all cells. Respiratory distress is a common symptom among patients with Pompe disease resulting from weakness of primary respiratory neuromuscular units of the diaphragm and genioglossus and the motor neurons which innervate them. The only FDA approved treatment is enzyme replacement therapy (ERT) of recombinant human GAA (rhGAA) which slows the decline of motor function and extends life expectancy.
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