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Ultrasound Assessment Of Diaphragmatic Function During Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Pilot Study

PURPOSE: Impairment of diaphragmatic function is one of the main pathophysiological mechanisms of chronic obstructive pulmonary disease (COPD) and is known to be related to acute exacerbation. Ultrasonography (US) allows for a simple, non-invasive assessment of diaphragm kinetics. The purpose of thi...

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Autores principales: Lim, Sung Yoon, Lim, Gajin, Lee, Yeon Joo, Cho, Young Jae, Park, Jong Sun, Yoon, Ho Il, Lee, Jae Ho, Lee, Choon-Taek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6844220/
https://www.ncbi.nlm.nih.gov/pubmed/31806957
http://dx.doi.org/10.2147/COPD.S214716
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author Lim, Sung Yoon
Lim, Gajin
Lee, Yeon Joo
Cho, Young Jae
Park, Jong Sun
Yoon, Ho Il
Lee, Jae Ho
Lee, Choon-Taek
author_facet Lim, Sung Yoon
Lim, Gajin
Lee, Yeon Joo
Cho, Young Jae
Park, Jong Sun
Yoon, Ho Il
Lee, Jae Ho
Lee, Choon-Taek
author_sort Lim, Sung Yoon
collection PubMed
description PURPOSE: Impairment of diaphragmatic function is one of the main pathophysiological mechanisms of chronic obstructive pulmonary disease (COPD) and is known to be related to acute exacerbation. Ultrasonography (US) allows for a simple, non-invasive assessment of diaphragm kinetics. The purpose of this study was to investigate the changes in diaphragmatic function during acute exacerbation of COPD, by US. METHODS: This single-center, prospective study included patients with acute exacerbation of COPD symptoms. US measurements were performed within 72 hrs after exacerbation and after improvement of symptoms. Diaphragmatic excursion and its thickening fraction (TF) were measured as markers of diaphragmatic function. TF was calculated as (thickness at end inspiration – thickness at end expiration)/thickness at end expiration. RESULTS: Ten patients were enrolled. All patients were male, and the mean age was 79.8 years. The TF of the right diaphragm showed a significant increase from the initial to the follow-up values (80.1 ± 104.9 mm vs. 159.5 ± 224.6 mm, p = 0.011); however, the diaphragmatic excursion did not vary significantly between the initial and follow-up values (22 ± 6 mm vs 23 ±12 mm). The change in excursion between the stable and exacerbation periods was positively correlated with time to the next exacerbation and negatively correlated with the time taken to recover from the exacerbation. CONCLUSION: These data support the possibility that a defect in diaphragm thickening is related to acute exacerbation of COPD.
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spelling pubmed-68442202019-12-05 Ultrasound Assessment Of Diaphragmatic Function During Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Pilot Study Lim, Sung Yoon Lim, Gajin Lee, Yeon Joo Cho, Young Jae Park, Jong Sun Yoon, Ho Il Lee, Jae Ho Lee, Choon-Taek Int J Chron Obstruct Pulmon Dis Original Research PURPOSE: Impairment of diaphragmatic function is one of the main pathophysiological mechanisms of chronic obstructive pulmonary disease (COPD) and is known to be related to acute exacerbation. Ultrasonography (US) allows for a simple, non-invasive assessment of diaphragm kinetics. The purpose of this study was to investigate the changes in diaphragmatic function during acute exacerbation of COPD, by US. METHODS: This single-center, prospective study included patients with acute exacerbation of COPD symptoms. US measurements were performed within 72 hrs after exacerbation and after improvement of symptoms. Diaphragmatic excursion and its thickening fraction (TF) were measured as markers of diaphragmatic function. TF was calculated as (thickness at end inspiration – thickness at end expiration)/thickness at end expiration. RESULTS: Ten patients were enrolled. All patients were male, and the mean age was 79.8 years. The TF of the right diaphragm showed a significant increase from the initial to the follow-up values (80.1 ± 104.9 mm vs. 159.5 ± 224.6 mm, p = 0.011); however, the diaphragmatic excursion did not vary significantly between the initial and follow-up values (22 ± 6 mm vs 23 ±12 mm). The change in excursion between the stable and exacerbation periods was positively correlated with time to the next exacerbation and negatively correlated with the time taken to recover from the exacerbation. CONCLUSION: These data support the possibility that a defect in diaphragm thickening is related to acute exacerbation of COPD. Dove 2019-11-07 /pmc/articles/PMC6844220/ /pubmed/31806957 http://dx.doi.org/10.2147/COPD.S214716 Text en © 2019 Lim et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Lim, Sung Yoon
Lim, Gajin
Lee, Yeon Joo
Cho, Young Jae
Park, Jong Sun
Yoon, Ho Il
Lee, Jae Ho
Lee, Choon-Taek
Ultrasound Assessment Of Diaphragmatic Function During Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Pilot Study
title Ultrasound Assessment Of Diaphragmatic Function During Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Pilot Study
title_full Ultrasound Assessment Of Diaphragmatic Function During Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Pilot Study
title_fullStr Ultrasound Assessment Of Diaphragmatic Function During Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Pilot Study
title_full_unstemmed Ultrasound Assessment Of Diaphragmatic Function During Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Pilot Study
title_short Ultrasound Assessment Of Diaphragmatic Function During Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Pilot Study
title_sort ultrasound assessment of diaphragmatic function during acute exacerbation of chronic obstructive pulmonary disease: a pilot study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6844220/
https://www.ncbi.nlm.nih.gov/pubmed/31806957
http://dx.doi.org/10.2147/COPD.S214716
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