{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:29:07Z","timestamp":1791566947386,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ultrasound\u2010based diaphragmatic assessments are becoming more common in pediatric acute care, but baseline pediatric diaphragm thickness and contractility values remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective, observational study of healthy children aged &lt;18 years undergoing elective surgery. Diaphragm thickness at end\u2010expiration (Tdi\u2010exp), thickening fraction (DTF) and excursion were measured by ultrasound during spontaneous breathing and during mechanical ventilation. Diaphragm strain and peak strain rate were ascertained post hoc. Measurements were compared across a priori specified age groups (&lt;1 year, 1 to &lt;3, 3 to &lt;6, 6 to &lt;12, and 12 to &lt;18 years) and with versus without mechanical ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty subjects were evaluated (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910 per age group). Baseline mean Tdi\u2010exp was 0.19\u2009\u00b1\u20090.04\u2009cm, DTF 0.19\u2009\u00b1\u20090.09, excursion 1.69\u2009\u00b1\u20090.97\u2009cm, strain \u221210.3\u2009\u00b1\u20094.9, peak strain rate \u22120.48\u2009\u00b1\u20090.21\u2009s\n                      <jats:sup>\u22121<\/jats:sup>\n                      . No significant difference in Tdi\u2010exp or DTF was observed across age groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009.05). Diaphragm excursion increased with age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Diaphragm strain was significantly greater in the 12\u201317\u2010year age group (\u221214.3\u2009\u00b1\u20096.4),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.048, but there were no age\u2010related differences in peak strain rate (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.08). During mechanical ventilation, there were significant decreases in DTF 0.12\u2009\u00b1\u20090.04 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001), excursion 1.08\u2009\u00b1\u20090.31\u2009cm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001), strain \u22124.60\u2009\u00b1\u20091.93 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001), and peak strain rate \u22120.20\u2009\u00b1\u20090.10\u2009s\n                      <jats:sup>\u22121<\/jats:sup>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001) while there was no change in Tdi\u2010exp 0.18\u2009\u00b1\u20090.03\u2009cm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.25) when compared to baseline values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric Tdi\u2010exp, DTF, and diaphragm peak strain rate were similar across age groups. Diaphragm excursion and strain varied across age groups. All measures of diaphragm contractility were diminished during mechanical ventilation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.26768","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T08:16:27Z","timestamp":1701418587000},"page":"433-441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Ultrasound assessment of diaphragm thickness, contractility, and strain in healthy pediatric patients"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1583-4609","authenticated-orcid":false,"given":"Christie L.","family":"Glau","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"},{"name":"Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaina E.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"},{"name":"Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"Conlon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"},{"name":"Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Himebauch","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Children's Hospital of Philadelphia Philadelphia Pennsylvania 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Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26768","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T09:17:35Z","timestamp":1706519855000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.26768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/ppul.26768"],"URL":"https:\/\/doi.org\/10.1002\/ppul.26768","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12]]},"assertion":[{"value":"2023-06-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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