ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 2  |  Page : 218-225

Assessment of ventilator-induced diaphragmatic dysfunction in patients with chronic obstructive pulmonary disease using transthoracic ultrasonography


Chest Department, Faculty of Medicine, Assiut University Hospital, Assuit, Egypt

Correspondence Address:
Shereen Farghaly
Chest Department, Faculty of Medicine, Assiut University Hospital, Assiut University Hospital, Assuit 7111
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejb.ejb_99_17

Rights and Permissions

Background Mechanical ventilation (MV) can cause progressive thinning of diaphragm muscle and hence progressive decrease in diaphragmatic function. We aimed to assess the rate at which diaphragm thickness (tdi) changed during MV and its effect on weaning outcome using transthoracic ultrasound (TUS) evaluation in patients with chronic obstructive pulmonary disease (COPD). Patients and methods Thirty mechanically ventilated patients with COPD were enrolled in this cohort study. Baseline tdi was recorded within 24 h of MV after stoppage of sedation using TUS. The subsequent measurements were recorded on the third, fifth, and seventh day of MV and at the time of initiation of weaning. Results There was a significant decrease in tdi at end expiration and at end inspiration by approximately 27.2 and 17% at third day of MV, respectively, and 35.5 and 18.5% at fifth day of MV, respectively, compared with baseline parameters. In the 10 patients who were still on ventilator till the seventh day, tdi were significantly lower compared with baseline recordings. Percentage of decrease of tdi at end inspiration from baseline recordings was significantly higher in patients with difficult weaning than in those with simple weaning. The optimum cutoff value of % of decline of tdi at end inspiration associated with difficult weaning was at least 10.6% giving 88.9% sensitivity and 83.3% specificity. Conclusion MV is associated with gradual diaphragmatic atrophy which can be detected by TUS and could predict weaning outcome in mechanically ventilated patients with COPD.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed198    
    Printed8    
    Emailed0    
    PDF Downloaded54    
    Comments [Add]    

Recommend this journal