Perioperative medicine & outcomes
Maximal inspiratory diaphragmatic ultrasound predicts postoperative pulmonary complications after upper abdominal surgery
Authors' conclusion
Postoperative maximal inspiratory diaphragmatic ultrasound measurements during deep and sniff breathing (quantified by a composite index, the post-RDS-DE) effectively predict PPCs following upper abdominal surgery.
Study context
- Population
- Patients aged ≥ 50 years undergoing elective upper abdominal surgery under GA
- Participants
- 223 patients
- Exposure
- post-RDS-DE vs ARISCAT
- Outcome
- PPCs
- Follow-up
- 14 days after surgery
Main finding
As reported in the abstract
Prediction of PPCs
post-RDS-DE
- AUC
- 0.680
- AUC 95% CI
- 0.587-0.773
- NPV (cutoff < 3.55 cm)
- 90.6%
post-RDS-DE
AUC0.680
AUC 95% CI0.587-0.773
NPV (cutoff < 3.55 cm)90.6%
Adjusted odds ratio (95% CI)P value
post-RDS-DE < 3.55 cmindependent predictor after multivariable adjustment
2.547(1.067–6.080)
P = 0.035- Integrated model (post-RDS-DE < 3.55 cm + ARISCAT) vs ARISCAT
- AUC 0.751 vs. 0.643; DeLong's P = 0.004
Observational data: associations, not effects.
Further findings
Incidence of postoperative pulmonary complications (PPCs) · 14 days after surgery
- Patients developing PPCs
- 37 (16.6%)
Diaphragmatic ultrasound parameters, POD1 vs preoperative
- All parameters significantly reduced postoperatively
- P < 0.001
Original publication
Maximal inspiratory diaphragmatic ultrasound predicts postoperative pulmonary complications after upper abdominal surgery. Ann Intensive Care. Published 18 August 2025. doi:10.
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