We prospectively followed all the adult patients who were consecutively admitted to the intensive care unit (ICU) after LT between September 2011 and September 2014. A thoracic echography was performed to all the patients with clinical criteria for diaphragmatic weakness. This was clinically suspected when weaning from the ventilator failed. The diaphragm function was evaluated in the M mode, diagnosing as diaphragmatic paresis all patients with a diaphragm excursion inferior to 9 mm (women) or 10 mm (men), or with a thickening fraction [(thickness at end-inspiration - thickness at end-expiration)/thickness at end-expiration] less to 20%, also qualitative discrimination were made between reduced and paradoxical inspiratory movement (1). We studied the association of confirmed diaphragmatic paresis with pneumonia and tracheobronchitis (2) as primary endpoints. Secondary endpoints were incidence of tracheostomy, days on the ventilator and in ICU and hospital mortality. Continuous data are reported as median and interquartile range and categorical data as numbers and percentages. Comparison was done using odds ratio (OR) and 95% confidence interval (CI), with absence of DP as reference.