EXpert consensus On Diaphragm UltraSonography in the critically ill (EXODUS): a Delphi consensus statement on the measurement of diaphragm ultrasound-derived parameters in a critical care setting

Background Diaphragm ultrasonography is rapidly evolving in both critical care and research. Nevertheless, methodologically robust guidelines on its methodology and acquiring expertise do not, or only partially, exist. Therefore, we set out to provide consensus-based statements towards a universal m...

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Vydáno v:Critical care (London, England) Ročník 26; číslo 1; s. 99 - 9
Hlavní autoři: Haaksma, Mark E., Smit, Jasper M., Boussuges, Alain, Demoule, Alexandre, Dres, Martin, Ferrari, Giovanni, Formenti, Paolo, Goligher, Ewan C., Heunks, Leo, Lim, Endry H. T., Mokkink, Lidwine B., Soilemezi, Eleni, Shi, Zhonghua, Umbrello, Michele, Vetrugno, Luigi, Vivier, Emmanuel, Xu, Lei, Zambon, Massimo, Tuinman, Pieter R.
Médium: Journal Article
Jazyk:angličtina
Vydáno: London BioMed Central 08.04.2022
BioMed Central Ltd
Springer Nature B.V
BMC
Témata:
Anatomy & physiology
Clinical medicine
Consensus
Critical Care
Critical Care Medicine
Critical Illness - therapy
Delphi
Delphi method
Delphi Technique
Diaphragm
Diaphragm (Anatomy)
Diaphragm - diagnostic imaging
Digital Object Identifier
Emergency Medicine
Human health and pathology
Humans
Intensive
Life Sciences
Literature reviews
Medicine
Medicine & Public Health
Methods
Physiology
Questionnaires
Surveys
Ultrasonic imaging
Ultrasonography
Ultrasound
Ultrasound imaging
Ventilators
Netherlands
Diaphragm
Ultrasound
Delphi
Consensus
ISSN:1364-8535, 1466-609X, 1364-8535, 1466-609X, 1366-609X
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Shrnutí:Background Diaphragm ultrasonography is rapidly evolving in both critical care and research. Nevertheless, methodologically robust guidelines on its methodology and acquiring expertise do not, or only partially, exist. Therefore, we set out to provide consensus-based statements towards a universal measurement protocol for diaphragm ultrasonography and establish key areas for research. Methods To formulate a robust expert consensus statement, between November 2020 and May 2021, a two-round, anonymous and online survey-based Delphi study among experts in the field was performed. Based on the literature review, the following domains were chosen: “Anatomy and physiology”, “Transducer Settings”, “Ventilator Impact”, “Learning and expertise”, “Daily practice” and “Future directions”. Agreement of ≥ 68% (≥ 10 panelists) was needed to reach consensus on a question. Results Of 18 panelists invited, 14 agreed to participate in the survey. After two rounds, the survey included 117 questions of which 42 questions were designed to collect arguments and opinions and 75 questions aimed at reaching consensus. Of these, 46 (61%) consensus was reached. In both rounds, the response rate was 100%. Among others, there was agreement on measuring thickness between the pleura and peritoneum, using > 10% decrease in thickness as cut-off for atrophy and using 40 examinations as minimum training to use diaphragm ultrasonography in clinical practice. In addition, key areas for research were established. Conclusion This expert consensus statement presents the first set of consensus-based statements on diaphragm ultrasonography methodology. They serve to ensure high-quality and homogenous measurements in daily clinical practice and in research. In addition, important gaps in current knowledge and thereby key areas for research are established. Trial registration The study was pre-registered on the Open Science Framework with registration digital object identifier https://doi.org/10.17605/OSF.IO/HM8UG .
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ISSN:1364-8535
1466-609X
1364-8535
1466-609X
1366-609X
DOI:10.1186/s13054-022-03975-5