Dynamic POCUS of Diaphragm Function to Predict Respiratory Failure in Septic Shock

This prospective observational cohort study aims to evaluate the prognostic value of serial bedside ultrasound assessment of diaphragmatic function in adult patients with septic shock. Diaphragmatic excursion, thickness, and thickening fraction will be assessed using point of care ultrasound at baseline and serially during the first 72 hours of intensive care admission. Dynamic changes in these parameters will be analyzed in relation to the development of respiratory failure, need for invasive mechanical ventilation, duration of mechanical ventilation, weaning and extubation outcomes, length of ICU stay, and mortality. The study will determine whether dynamic diaphragmatic ultrasound assessment can provide an early, non-invasive predictor of respiratory failure and adverse clinical outcomes in patients with septic shock.

Inclusion Criteria: * Age ≥ 18 years old. * Patients with septic shock. * Patients with ICU admission during study period. * Expected ICU stay for at least 72 hours. * Informed consent from the patient or legal guardian when required. Exclusion Criteria: * Age less than 18 years old. * Pre-existing neuromuscular disorders affecting respiratory muscles. * Known diaphragmatic paralysis or diaphragmatic palsy. * Significant phrenic nerve injury. * Cervical spinal cord injury. * Advanced chronic neuromuscular disease. * Previous major thoracic or diaphragmatic surgery. * Severe chest wall deformity. * Conditions preventing adequate diaphragmatic ultrasound assessment. * Pregnancy, if required by local ethical policy. * Patients with limitations of care that preclude full respiratory support. * Refusal of consent where consent is required.