{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T03:11:40Z","timestamp":1788577900465,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate diaphragmatic muscle behavior via ultrasound in children over the course of invasive mechanical ventilation in a PICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An observational, longitudinal, quantitative study was conducted in a PICU, including children on IMV for more than 48\u2009h. Ultrasound assessments were performed on the first, third, and seventh days of IMV. Measurements included inspiratory and expiratory diaphragmatic thickness, thickening fraction, diaphragmatic excursion, and diaphragmatic slope.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A significant reduction in inspiratory thickness (Tdi), expiratory thickness (TDe), and diaphragmatic excursion (DE) was observed over the IMV period (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), while the diaphragmatic thickening fraction (DTF) showed a progressive increase (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The diaphragmatic slope showed a downward trend, though not statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06). Patients who received neuromuscular blocking agents (NMBA) exhibited lower DTF values, with a strong correlation (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.79;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diaphragmatic ultrasound demonstrated the ability to detect morphofunctional changes in the diaphragm during IMV in children throughout their PICU stay. The observed changes\u2014particularly in diaphragmatic thickness, excursion, and thickening fraction associated with the use of NMBAs\u2014reinforce the potential of ultrasound as a monitoring tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcu.70393","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T02:12:21Z","timestamp":1788574341000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diaphragm Ultrasonography Reveals Progressive Changes in Diaphragmatic Function, Morphology, and Muscle Trophism During Invasive Mechanical Ventilation in Children"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3688-2947","authenticated-orcid":false,"given":"Juliana Bezerra","family":"dos Santos","sequence":"first","affiliation":[{"name":"Universidade do Estado do Par\u00e1\u2014UEPA  Bel\u00e9m Brazil"},{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Reabilita\u00e7\u00e3o e Desempenho Funcional Universidade do Estado do Par\u00e1\u2014UEPA  Bel\u00e9m Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8627-5694","authenticated-orcid":false,"given":"Emmerson Carlos Franco","family":"de Farias","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1  Bel\u00e9m Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4223-692X","authenticated-orcid":false,"given":"Mary Lucy Ferraz Maia Fiuza","family":"de Mello","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Santa Casa de Miseric\u00f3rdia do Par\u00e1  Bel\u00e9m Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5964-946X","authenticated-orcid":false,"given":"Rodrigo Santiago Barbosa","family":"Rocha","sequence":"additional","affiliation":[{"name":"Universidade do Estado do Par\u00e1\u2014UEPA  Bel\u00e9m Brazil"},{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Reabilita\u00e7\u00e3o e Desempenho Funcional Universidade do Estado do Par\u00e1\u2014UEPA  Bel\u00e9m 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