General Standardization of transducer settings and technique is necessary Basic science Histological changes caused by ventilation should be investigated (e.g. inflammation, fibrosis, oedema) The histological basis of the middle hyperechogenic layer should be determined Cut-offs for diaphragm dysfunction in various clinical settings should be determined The interaction with other respiratory muscles, e.g. the impact of expiratory muscle atrophy/dysfunction on diaphragm function, should be investigated Indications in clinical practice Effective ultrasonographic parameter to accurately estimate work of breathing should be investigated The use of ultrasonography as screening tool to identify patient–ventilator asynchrony should be investigated The role of diaphragm ultrasonography to effectively titrate ventilator settings (i.e. diaphragm protective ventilation) should be investigated The role of diaphragm ultrasonography in non-invasive ventilation (e.g. as predictor of liberation from mechanical ventilation or to titrate support settings) should be investigated Automation of image acquisition New techniques of interest for diaphragm ultrasonography Shear wave elastography Speckle tracking Diaphragm acceleration as parameter for (dys-)function Automated image collection for monitoring purposes |