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

被引:24
作者
Lim, Sung Yoon [1 ]
Lim, Gajin [2 ]
Lee, Yeon Joo [1 ]
Cho, Young Jae [1 ]
Park, Jong Sun [1 ]
Yoon, Ho Il [1 ,2 ]
Lee, Jae Ho [1 ,2 ]
Lee, Choon-Taek [1 ,3 ]
机构
[1] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Div Pulmonol & Crit Care Med, Seongnam, South Korea
[2] Cheongju Hana Hosp, Dept Internal Med, Div Pulmonol Med, Cheongju, South Korea
[3] Seoul Natl Univ, Coll Med, Dept Internal Med, Div Pulmonol & Crit Care Med, 82 Gumi Ro,173beon Gil, Seoul, South Korea
来源
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE | 2019年 / 14卷
关键词
ultrasonography; diaphragmatic excursion; diaphragmatic thickening; exacerbation; chronic obstructive pulmonary disease; MECHANICAL VENTILATION; DYSFUNCTION; ULTRASONOGRAPHY; DIAGNOSIS; OUTCOMES; IMPACT; COPD;
D O I
10.2147/COPD.S214716
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
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.
引用
收藏
页码:2479 / 2484
页数:6
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