Uso de ultrasonido diafragmático como herramienta de evaluación no invasiva en cuidados intensivos: revisión sistemática
Palabras clave:
Ultrasonografía, ventilación mecánica, unidades de cuidados intensivos, (Fuente: DECS)
Resumen
El objetivo es explorar la evidencia sobre el uso de ultrasonido diafragmático como herramienta de evaluación no invasiva en pacientes con ventilación mecánica en UCI en el período 2020 a 2025. Se desarrolla una revisión de alcance, incluyendo 26 estudios de PubMed, Embase y Web of Science, de 2020 a 2025. Se reportaron cortes de excursión entre 1,1 y 1,8 cm con curvas ROC 0,79-0,94 y sensibilidades superiores a 80%; la fracción inferior al 25% duplicó la probabilidad de reintubación y, combinada con frecuencia respiratoria, elevó la exactitud diagnóstica; el índice DTF-RSBI superó RSBI tradicional y redujo días de ventilación; la postura sentada incrementó la excursión y mejoró la capacidad predictiva, mientras IntelliVent-ASV atenuó la pérdida de grosor frente a PS-SIMV; la fracción tras dos horas de ventilación no invasiva identificó con AUROC 0,94 a quienes fracasarían. La ecografía diafragmática complementa los criterios clásicos de destete y favorece intervenciones tempranas.
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Citas
Alay, G. H., Tatlisuluoglu, D., y Turan, G. (2023). Evaluation of IntelliVent-ASV® and PS-SIMV mode using ultrasound (us) measurements in terms of diaphragm atrophy. Cureus 15(6). https://doi.org/10.7759/cureus.40244
Ashhar, M. S., Kumar, C. S., Venu, M., Maneesha, P., Reddy, R. R., y Kusuma, M. (2024). Innovative use of diaphragmatic ultrasound to enhance prediction of weaning success from mechanical ventilation in intensive care units. Journal of Cardiovascular Disease Research, 15(9). https://jcdronline.org/index.php/JCDR/article/view/12243
Chung, E., Leem, A. Y., Lee, S. H., Kang, Y. A., Kim, Y. S., y Chung, K. S. (2024). Predicting successfulweaning through sonographic measurement of the rapid shallow breathing index. J. Clin. Med, 013(4809). https://doi.org/10.3390/jcm13164809
Cordeiro Madeira, L., de Tarso Dalcin, P., Heinen Schuster, G., Conte, B., Michel Wolf, J., y Schreiber, A. (2024). Lung ultrasound score and diaphragm ultrasound in weaning from mechanical ventilation: are they different in patients with and without COVID-19? J. bras. Pneumol, 50(5). https://doi.org/10.36416/1806-3756/e20240302
Demoule, A., Fossé, Q., Mercat, A., Bergum, D., Virolle, S., y Bureau, C. (2024).Operator independent continuous ultrasound monitoring of diaphragm excursion predicts successful weaning from mechanical ventilation: a prospective observational study. Critical Care, 28(245). https://doi.org/10.1186/s13054-024-05003-0
Dres, M., Doorduin, J., Boussouar, S., y Bachasson, D. (2025). Advancements in imaging techniques for monitoring the respiratory muscles. Critical Care, 29(110). https://doi.org/10.1186/s13054-025-05339-1
Fonseca, C., Novoa, C., Aguayo, M., Arriagada, R., Alvarado, C., Pedreros, C. (2024). Predictive value of diaphragm and lung ultrasonography for weaning failure in critically Ill patients with acute respiratory failure due to COVID-19 Pneumonia. Diagnostics, 14(2263). https://doi.org/10.3390/diagnostics14202263
Inci, K., Macit Aydın, E., Aygencel, G., Türkoğlu, M. (2024). Association between nutritional risk status and both diaphragmatic dysfunction and diaphragm atrophy in medical intensive care unit patients. Nutr Hosp, 3(1022). https://doi.org/10.20960/nh.05011
Itagaki, T., Akimoto, Y., Takashima, T., Oto, J. (2024). Ultrasonographic assessment of the diaphragm. Diagnostics, 14(1481). https://doi.org/10.3390/diagnostics14141481
Kheir, M., Dong, V., Roselli, V., Mina, B. (2023). The role of ultrasound in predicting non-invasive ventilation outcomes: a systematic review. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1233518
Kumar, N., Neeraj, N., Prasad, S., y Kumar, R. (2024). Comparative study between the use of ultrasonic criteria of weaning versus the conventional criteria of weaning in post-traumatic acute respiratory distress syndrome patients who were ventilated for a long time. Student’s Journal of Health Research Africa, 5(11). https://doi.org/10.51168/sjhrafrica.v5i11.1749
Landeros Yáñez, J. C. (2023). Correlación de la función diafragmática medida por ultrasonido en comparación con la fuerza inspiratoria negativa, como predictores de destete ventilatorio en pacientes críticamente enfermos. Med Crit, 37(8). https://doi.org/10.35366/115226
Lin, H., Yao, M., Qin, Z., Fu, S., y Wang, H. (2024). Predictive values of ultrasonic diaphragm thickening fraction combined with integrative weaning index in weaning patients with mechanical ventilation: a retrospective study. Journal of Cardiothoracic Surgery, 19(66). https://doi.org/10.1186/s13019-024-02544-x
Liu, Y., Zhou, Y., Liu, P., Ying, W., Wu, H., y Dong, Z. (2024).Combined lung and diaphragm ultrasound predicts extubation outcomes in ARDS: a prospective study. European Journal of Medical Research, 29(510). https://doi.org/10.1186/s40001-024-02103-z
Luo, L., Li, Y., Wang, L., Sun, B., y Tong, Z. (2024).Ultrasound evaluation of cardiac and diaphragmatic function at different positions during a spontaneous breathing trial predicting extubation outcomes: a retrospective cohort study. BMC Medical Imaging, 24(217). https://doi.org/10.1186/s12880-024-01357-7
Pan, L., Zhao, J., Wang, X., Huang, L., Li, S., y Sun, S. (2024).Value of diaphragmatic ultrasound parameters in assessing weaning outcomes and survival in ventilator-dependent intensive care unit patients. Am J Transl Res, 16(12). https://doi.org/10.62347/FDPE7053
Parada Gereda, H. M., Tibaduiza, A. L., Rico Mendoza, A., Molano Franco, D., Nieto, V. H., y Arias Ortiz, W. A. (2023). Effectiveness of diaphragmatic ultrasound as a predictor of successful weaning from mechanical ventilation: a systematic review and meta-analysis. Critical Care, 27(174). https://doi.org/10.1186/s13054-023-04430-9
Pham, T., Heunks, L., Bellani, G., Madotto, F., Aragao, I., Beduneau, G. (2023). Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study. The Lancet Respiratory Medicine, 11(5). https://doi.org/10.1016/S2213-2600(22)00449-0
Poddighe, D., Van Hollebeke, M., Choudhary, Y. Q., Ribeiro Campos, D., Schaeffer, M. R., y Verbakel, J. Y. (2024). Accuracy of respiratory muscle assessments to predict weaning outcomes: a systematic review and comparative meta analysis. Critical Care, 28(70). https://doi.org/10.1186/s13054-024-04823-4
Rodríguez Serrano, D. A., Pérez Terán, P., Blancas, R., y Arroyo, M. (2023). Ecografía pleuropulmonar y diafragmática en medicina intensiva. Medicina Intensiva, 47(1). https://doi.org/10.1016/j.medin.2023.06.013
Rosenthal, V. D., Yin, R., Nercelles, P., Rivera Molina, S. E., Jyoti, S., y Dongol, R. (2024). International Nosocomial Infection Control Consortium (INICC) report of health care associated infections, data summary of 45 countries for 2015 to 2020, adult and pediatric units, device-associated module. American Journal of Infection Control, 52(9). https://doi.org/10.1016/j.ajic.2023.12.019
Song, J., Qian, Z., Zhang, H., Wang, M., Yu, Y., y Ye, C. (2022). Diaphragmatic ultrasonography based rapid shallow breathing index for predicting weaning outcome during a pressure support ventilation spontaneous breathing trial. BMC Pulmonary Medicine, 22(337). https://doi.org/10.1186/s12890-022-02133-5
Suttapanit, K., Lerdpaisarn, P., Charoensuksombun, C., Sanguanwit, P., y Supatanakij, P. (2025). Diaphragmatic ultrasonographic evaluation asan assessment guide for predicting noninvasiveventilation failure in acute exacerbation ofchronic obstructive pulmonary disease. The American Journal of Emergency Medicine, 93(1). https://doi.org/10.1016/j.ajem.2025.03.025
Tamayo González, I. E., Ruiz Serna, O. H., y Guzmán, D. G. (2024). Ecografía de diafragma en unidad de cuidados intensivos “UCI”. Revista Politécnica, 20(39). https://doi.org/10.33571/rpolitec.v20n39a9
Vélez Páez, J. L., Aguayo Moscoso, S. X., Castro Bustamante, C., Montalvo Villagómez, M., Jara González, F., y Baldeón Rojas, L. (2023). Biomarkers as predictors of mortality in critically ill obese patients with COVID-19 at high altitude. BMC Pulm Med, 23(1). https://doi.org/10.1186/s12890-023-02399-3
Vélez Páez, J. L., Pelosi, P., Battaglini, D., y Best, I. (2023). Biological markers topredict outcome in mechanically ventilated patients with severe COVID-19 Living at high altitude. J Clin Med, 12(2). https://doi.org/10.3390/jcm12020644
Vieira Santana, P., Zumpano Cardenas, L., y Pereira de Albuquerque, A. L. (2023). Diaphragm ultrasound in critically ill patients on mechanical ventilation—evolving concepts. Diagnostics, 13(6). https://doi.org/10.3390/diagnostics13061116
Xie, D., Xu, H., Wang, F., Wen, W., y Dong, B. (2025). Diagnostic accuracy of rapid shallow breathingindex based on diaphragm ultrasoundpredicting successful weaning from mechanicalventilation: A systematic review and meta-analysis. Intensive and Critical Care Nursing, 90(104038). https://doi.org/10.1016/j.iccn.2025.104038
Zhang, T., Liu, Y., Xu, D., Dong, R., y Song, Y. (2024). Diaphragmatic Dynamics assessed by bedside ultrasound predict extubation in the intensive care unit: a prospective observational study. Int J Gen Med, 18(17). https://doi.org/10.2147/IJGM.S487999
Ashhar, M. S., Kumar, C. S., Venu, M., Maneesha, P., Reddy, R. R., y Kusuma, M. (2024). Innovative use of diaphragmatic ultrasound to enhance prediction of weaning success from mechanical ventilation in intensive care units. Journal of Cardiovascular Disease Research, 15(9). https://jcdronline.org/index.php/JCDR/article/view/12243
Chung, E., Leem, A. Y., Lee, S. H., Kang, Y. A., Kim, Y. S., y Chung, K. S. (2024). Predicting successfulweaning through sonographic measurement of the rapid shallow breathing index. J. Clin. Med, 013(4809). https://doi.org/10.3390/jcm13164809
Cordeiro Madeira, L., de Tarso Dalcin, P., Heinen Schuster, G., Conte, B., Michel Wolf, J., y Schreiber, A. (2024). Lung ultrasound score and diaphragm ultrasound in weaning from mechanical ventilation: are they different in patients with and without COVID-19? J. bras. Pneumol, 50(5). https://doi.org/10.36416/1806-3756/e20240302
Demoule, A., Fossé, Q., Mercat, A., Bergum, D., Virolle, S., y Bureau, C. (2024).Operator independent continuous ultrasound monitoring of diaphragm excursion predicts successful weaning from mechanical ventilation: a prospective observational study. Critical Care, 28(245). https://doi.org/10.1186/s13054-024-05003-0
Dres, M., Doorduin, J., Boussouar, S., y Bachasson, D. (2025). Advancements in imaging techniques for monitoring the respiratory muscles. Critical Care, 29(110). https://doi.org/10.1186/s13054-025-05339-1
Fonseca, C., Novoa, C., Aguayo, M., Arriagada, R., Alvarado, C., Pedreros, C. (2024). Predictive value of diaphragm and lung ultrasonography for weaning failure in critically Ill patients with acute respiratory failure due to COVID-19 Pneumonia. Diagnostics, 14(2263). https://doi.org/10.3390/diagnostics14202263
Inci, K., Macit Aydın, E., Aygencel, G., Türkoğlu, M. (2024). Association between nutritional risk status and both diaphragmatic dysfunction and diaphragm atrophy in medical intensive care unit patients. Nutr Hosp, 3(1022). https://doi.org/10.20960/nh.05011
Itagaki, T., Akimoto, Y., Takashima, T., Oto, J. (2024). Ultrasonographic assessment of the diaphragm. Diagnostics, 14(1481). https://doi.org/10.3390/diagnostics14141481
Kheir, M., Dong, V., Roselli, V., Mina, B. (2023). The role of ultrasound in predicting non-invasive ventilation outcomes: a systematic review. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1233518
Kumar, N., Neeraj, N., Prasad, S., y Kumar, R. (2024). Comparative study between the use of ultrasonic criteria of weaning versus the conventional criteria of weaning in post-traumatic acute respiratory distress syndrome patients who were ventilated for a long time. Student’s Journal of Health Research Africa, 5(11). https://doi.org/10.51168/sjhrafrica.v5i11.1749
Landeros Yáñez, J. C. (2023). Correlación de la función diafragmática medida por ultrasonido en comparación con la fuerza inspiratoria negativa, como predictores de destete ventilatorio en pacientes críticamente enfermos. Med Crit, 37(8). https://doi.org/10.35366/115226
Lin, H., Yao, M., Qin, Z., Fu, S., y Wang, H. (2024). Predictive values of ultrasonic diaphragm thickening fraction combined with integrative weaning index in weaning patients with mechanical ventilation: a retrospective study. Journal of Cardiothoracic Surgery, 19(66). https://doi.org/10.1186/s13019-024-02544-x
Liu, Y., Zhou, Y., Liu, P., Ying, W., Wu, H., y Dong, Z. (2024).Combined lung and diaphragm ultrasound predicts extubation outcomes in ARDS: a prospective study. European Journal of Medical Research, 29(510). https://doi.org/10.1186/s40001-024-02103-z
Luo, L., Li, Y., Wang, L., Sun, B., y Tong, Z. (2024).Ultrasound evaluation of cardiac and diaphragmatic function at different positions during a spontaneous breathing trial predicting extubation outcomes: a retrospective cohort study. BMC Medical Imaging, 24(217). https://doi.org/10.1186/s12880-024-01357-7
Pan, L., Zhao, J., Wang, X., Huang, L., Li, S., y Sun, S. (2024).Value of diaphragmatic ultrasound parameters in assessing weaning outcomes and survival in ventilator-dependent intensive care unit patients. Am J Transl Res, 16(12). https://doi.org/10.62347/FDPE7053
Parada Gereda, H. M., Tibaduiza, A. L., Rico Mendoza, A., Molano Franco, D., Nieto, V. H., y Arias Ortiz, W. A. (2023). Effectiveness of diaphragmatic ultrasound as a predictor of successful weaning from mechanical ventilation: a systematic review and meta-analysis. Critical Care, 27(174). https://doi.org/10.1186/s13054-023-04430-9
Pham, T., Heunks, L., Bellani, G., Madotto, F., Aragao, I., Beduneau, G. (2023). Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study. The Lancet Respiratory Medicine, 11(5). https://doi.org/10.1016/S2213-2600(22)00449-0
Poddighe, D., Van Hollebeke, M., Choudhary, Y. Q., Ribeiro Campos, D., Schaeffer, M. R., y Verbakel, J. Y. (2024). Accuracy of respiratory muscle assessments to predict weaning outcomes: a systematic review and comparative meta analysis. Critical Care, 28(70). https://doi.org/10.1186/s13054-024-04823-4
Rodríguez Serrano, D. A., Pérez Terán, P., Blancas, R., y Arroyo, M. (2023). Ecografía pleuropulmonar y diafragmática en medicina intensiva. Medicina Intensiva, 47(1). https://doi.org/10.1016/j.medin.2023.06.013
Rosenthal, V. D., Yin, R., Nercelles, P., Rivera Molina, S. E., Jyoti, S., y Dongol, R. (2024). International Nosocomial Infection Control Consortium (INICC) report of health care associated infections, data summary of 45 countries for 2015 to 2020, adult and pediatric units, device-associated module. American Journal of Infection Control, 52(9). https://doi.org/10.1016/j.ajic.2023.12.019
Song, J., Qian, Z., Zhang, H., Wang, M., Yu, Y., y Ye, C. (2022). Diaphragmatic ultrasonography based rapid shallow breathing index for predicting weaning outcome during a pressure support ventilation spontaneous breathing trial. BMC Pulmonary Medicine, 22(337). https://doi.org/10.1186/s12890-022-02133-5
Suttapanit, K., Lerdpaisarn, P., Charoensuksombun, C., Sanguanwit, P., y Supatanakij, P. (2025). Diaphragmatic ultrasonographic evaluation asan assessment guide for predicting noninvasiveventilation failure in acute exacerbation ofchronic obstructive pulmonary disease. The American Journal of Emergency Medicine, 93(1). https://doi.org/10.1016/j.ajem.2025.03.025
Tamayo González, I. E., Ruiz Serna, O. H., y Guzmán, D. G. (2024). Ecografía de diafragma en unidad de cuidados intensivos “UCI”. Revista Politécnica, 20(39). https://doi.org/10.33571/rpolitec.v20n39a9
Vélez Páez, J. L., Aguayo Moscoso, S. X., Castro Bustamante, C., Montalvo Villagómez, M., Jara González, F., y Baldeón Rojas, L. (2023). Biomarkers as predictors of mortality in critically ill obese patients with COVID-19 at high altitude. BMC Pulm Med, 23(1). https://doi.org/10.1186/s12890-023-02399-3
Vélez Páez, J. L., Pelosi, P., Battaglini, D., y Best, I. (2023). Biological markers topredict outcome in mechanically ventilated patients with severe COVID-19 Living at high altitude. J Clin Med, 12(2). https://doi.org/10.3390/jcm12020644
Vieira Santana, P., Zumpano Cardenas, L., y Pereira de Albuquerque, A. L. (2023). Diaphragm ultrasound in critically ill patients on mechanical ventilation—evolving concepts. Diagnostics, 13(6). https://doi.org/10.3390/diagnostics13061116
Xie, D., Xu, H., Wang, F., Wen, W., y Dong, B. (2025). Diagnostic accuracy of rapid shallow breathingindex based on diaphragm ultrasoundpredicting successful weaning from mechanicalventilation: A systematic review and meta-analysis. Intensive and Critical Care Nursing, 90(104038). https://doi.org/10.1016/j.iccn.2025.104038
Zhang, T., Liu, Y., Xu, D., Dong, R., y Song, Y. (2024). Diaphragmatic Dynamics assessed by bedside ultrasound predict extubation in the intensive care unit: a prospective observational study. Int J Gen Med, 18(17). https://doi.org/10.2147/IJGM.S487999
Publicado
2026-01-01
Cómo citar
Verdezoto-Pinto, Y., Olaya-Pincay, M., Rosado-Mendoza, P., & Yaguache-Jimbo, A. (2026). Uso de ultrasonido diafragmático como herramienta de evaluación no invasiva en cuidados intensivos: revisión sistemática. CIENCIAMATRIA, 12(22), 45-63. https://doi.org/10.35381/cm.v12i22.1997
Sección
De Investigación
Derechos de autor 2026 Yerling Marina Verdezoto-Pinto, María Elena Olaya-Pincay, Pamela Elizabeth Rosado-Mendoza, Andrea Lucia Yaguache-Jimbo
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