Supplementary Material for: Ultrasonography in Assessment of Respiratory Muscles Function: A Systematic Review

Introduction: The purpose of this study was to evaluate the potential utility of respiratory muscles ultrasound (US) imaging for assessing respiratory function and identify US variables that best correlate with pulmonary parameters. Materials and Methods: A search of 5 databases was conducted. Initially, there was no language, study design, or time frame restrictions. All studies assessing the relationship between pulmonary and US parameters were included. Two reviewers independently extracted and documented data regarding to examined population, age, gender, health condition, methodology, US, and pulmonary function measurements. All studies were qualitative synthesis. Results: A total of 1,272 participants from 31 studies were included. Diaphragm thickness, diaphragm thickening ratio, and diaphragm excursion amplitude were mainly used as US parameters. Forced vital capacity, forced expiratory volume1sec, and maximal inspiratory pressure were mainly used as pulmonary parameters. The relationships between pulmonary and US parameters varied from negligible to strong (depend on examined population and methodology used). Data were not quantitatively synthesis due to high heterogeneity in terms of study design, population examined, and various pulmonary and US parameters. Conclusion: A strong relationship between US measurements and pulmonary parameters was demonstrated in some studies but not others. This review confirmed that US measurements can complement spirometry, but the exact role of the US remains to be confirmed. Further studies using standardized methodology are needed to obtain more conclusive evidence on the usefulness of US for assessing respiratory function.引言：本研究旨在评估呼吸肌超声（US）成像在评估呼吸功能方面的潜在应用价值，并筛选出与肺参数相关性最优的超声变量。 材料与方法：共检索5个数据库，初始检索未设置语言、研究设计及时间范围限制，纳入所有探讨肺参数与超声参数之间关联的研究。由两名评价员独立提取并记录研究人群、年龄、性别、健康状况、研究方法、超声及肺功能测量指标等相关数据。所有研究均采用定性综合法进行分析。 结果：最终纳入31项研究，共1272名受试者。超声参数主要采用膈肌厚度、膈肌增厚率及膈肌移动幅度；肺参数主要采用用力肺活量、1秒用力呼气容积及最大吸气压。肺参数与超声参数间的相关性从微弱至极强不等，具体取决于研究人群及所采用的研究方法。由于研究设计、受试人群以及所用肺参数与超声参数均存在较高异质性，故未进行定量综合分析。 结论：部分研究证实超声测量值与肺参数间存在较强相关性，但其余研究并未得出此结论。本综述确认超声测量可作为肺量测定法的补充手段，但其确切作用仍有待进一步验证。未来需采用标准化研究方法开展相关研究，以获取关于超声评估呼吸功能实用性的更确凿证据。