Respiratory failure & ventilation
Diaphragm physiological similarity index (DPSI): a de Novo speckle-tracking ultrasound metric for high-flow nasal cannula (HFNC) adjustment in acute respiratory failure
Authors' conclusion
DPSI is a feasible and reproducible speckle-tracking ultrasound metric that quantifies diaphragmatic motion patterns and distinguishes healthy from impaired contraction trajectories.
Study context
- Population
- Healthy volunteers, intensive care unit (ICU) patients and patients with acute respiratory failure on HFNC
- Participants
- 103 volunteers
- Exposure
- Healthy volunteers vs ICU vs acute respiratory failure (ARF)
- Healthy volunteersn = 45reference
- ICUn = 38
- ARFn = 20
- Outcome
- Reproducibility and physiological responsiveness of DPSI
Methodological detailsspeckle-tracking ultrasound, prespecified stepwise HFNC flow adjustment protocol
- Speckle-tracking ultrasound
- Prespecified stepwise HFNC flow adjustment protocol
Main finding
As reported in the abstract
- Mean inspiratory velocity reproducibility (ICC)
- 0.87
- Peak displacement reproducibility (ICC)
- 0.69
- DPSI reproducibility (ICC)
- 0.75
- DPSI association with ROX index (R²; p < 0.001)
- 0.62
- DPSI association with peak diaphragmatic excursion (R²; p < 0.001)
- 0.60
Observational data: associations, not effects.
Original publication
Diaphragm physiological similarity index (DPSI): a de Novo speckle-tracking ultrasound metric for HFNC adjustment in acute respiratory failure. Crit Care. Published 26 February 2026. doi:10.
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