{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:09:34Z","timestamp":1784128174598,"version":"3.55.0"},"reference-count":14,"publisher":"Medical Communications Sp. z.o.o.","issue":"105","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Ultrason"],"abstract":"<jats:p>Aim: Early identification of patients likely to require ventilatory support is a key emergency department priority. Bedside diaphragm ultrasound provides a rapid assessment of respiratory muscle function, and the diaphragm thickening fraction quantifies diaphragmatic contraction during tidal breathing. Material and methods: In this prospective observational pilot study, adults with acute respiratory failure in a single emergency department underwent diaphragm ultrasound within 6 hours of presentation. The primary outcome was initiation of non-invasive ventilation or invasive mechanical ventilation from emergency department presentation through hospitalization. Results: Among 56 patients, 22 (39%) required ventilatory support. Diaphragm thickening fraction was lower in those requiring support (median 20.93% vs 29.8%; p = 0.006). Higher diaphragm thickening fraction was associated with lower odds of ventilatory support (OR 0.93 per 1% increase, 95% CI 0.88\u20130.98; p = 0.008). Discriminative ability was moderate (AUC 0.72, 95% CI 0.58\u20130.87), and the optimal cutoff was 22.1% (sensitivity 59%, specificity 71%). Conclusions: Early emergency department assessment of diaphragm thickening fraction may help identify patients at increased risk of requiring ventilatory support.<\/jats:p>","DOI":"10.15557\/jou.2026.0013","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:49:38Z","timestamp":1784126978000},"source":"Crossref","is-referenced-by-count":0,"title":["Diaphragm thickening fraction as a predictor of the need for ventilatory support in the emergency department: an observational pilot study"],"prefix":"10.15557","volume":"26","author":[{"given":"Carmine Cristiano","family":"Di Gioia","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Azienda Ospedaliero-Universitaria di Modena, Community Hospital of Baggiovara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Alame","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Azienda Ospedaliero-Universitaria di Modena, Community Hospital of Baggiovara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Lucrezia","family":"Grisan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, University of Modena and Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmarco","family":"Sicuranza","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Azienda Ospedaliero-Universitaria di Modena, Community Hospital of Baggiovara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Ollari","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Azienda Ospedaliero-Universitaria di Modena, Community Hospital of Baggiovara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Orlando","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Azienda Ospedaliero-Universitaria di Modena, Community Hospital of Baggiovara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Orso","sequence":"additional","affiliation":[{"name":"Department of Emergency, Udine University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6250","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"1. 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