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Sonographic evaluation of diaphragmatic dysfunction in COPD patients.

Scheibe N, Sosnowski N, Pinkhasik A, Vonderbank S, Bastian A - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: Lung function parameters, blood gases, and 6-minute walk test were also collected and compared to the sonographic results.The sonographic measurement of the lung silhouette was easy to perform in all study participants.There was also a strong correlation between the demonstrated sonographic measurement of the up- and downward movement of the lung silhouette and the forced expiratory volume in the first second (r=0.83).

View Article: PubMed Central - PubMed

Affiliation: Department of Pneumonology, Marienkrankenhaus Kassel, Kassel, Germany.

ABSTRACT

Background: Diaphragmatic dysfunction is an important reason for dyspnea in COPD patients. But diaphragmatic dysfunction is difficult to evaluate. Ultrasound is an option. We measure sonographically the up- and downward movement of the lung silhouette on both hemidiaphragms. The aim of this prospective investigation was to compare this method with another sonographic method that visualizes the right hemidiaphragm directly and to compare the sonographic results with lung function parameters.

Methods and patients: Eighty participants - 20 healthy persons and 60 COPD patients - three groups each with 20 patients with COPD GOLD II, III, and IV - were investigated. The sonographic measurements of the diaphragms were performed. Lung function parameters, blood gases, and 6-minute walk test were also collected and compared to the sonographic results.

Results: The sonographic measurement of the lung silhouette was easy to perform in all study participants. The correlation between the sonographic methods measuring the right hemidiaphragmatic movement was strong (r=0.85). There was also a strong correlation between the demonstrated sonographic measurement of the up- and downward movement of the lung silhouette and the forced expiratory volume in the first second (r=0.83).

Conclusion: We demonstrated that the sonographic measurement of the movement of the lung silhouette is an easy way to establish diaphragmatic dysfunction in COPD patients; it can be done in all patients with reliable results for the right and the left hemidiaphragm.

No MeSH data available.


Related in: MedlinePlus

Sonografic measurement of the maximum lung movement.Notes: (A) Sonographic measurement of the up- and downward movement of the lung silhouette – here on the right side. E marks the lowest point of the lung silhouette at maximal end expiration. (B) Sonographic measurement of the up- and downward movement of the lung silhouette – here on the right side. E marks the lowest point of the lung silhouette at maximal end expiration, and I marks the lowest point at maximal inspiration. In this example, the distance between E and I is 28 mm.
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f2-copd-10-1925: Sonografic measurement of the maximum lung movement.Notes: (A) Sonographic measurement of the up- and downward movement of the lung silhouette – here on the right side. E marks the lowest point of the lung silhouette at maximal end expiration. (B) Sonographic measurement of the up- and downward movement of the lung silhouette – here on the right side. E marks the lowest point of the lung silhouette at maximal end expiration, and I marks the lowest point at maximal inspiration. In this example, the distance between E and I is 28 mm.

Mentions: All participants were evaluated in a sitting position. Ultrasound was performed with a Hitachi ultrasound system (Sono MR, EUB-7500 HV) using a 3.5 MHz curved probe. The transducer was placed at the lowest part of the lung silhouette in the scapular line (Figure 1). The participant was instructed to exhale as deeply as possible (to RV) and then to inhale deeply to total lung capacity. This maneuver was filmed, and afterward, the distance between the highest and the lowest point of the lung silhouette was measured (Figure 2A and B). This maneuver was performed on the right and the left side. For comparison between this method and the anterior method, only the right side value was used because the anterior method was only used on the right side because of the well-known difficulties on the left side with the anterior method.20,21,24,27,29 The median value was calculated.


Sonographic evaluation of diaphragmatic dysfunction in COPD patients.

Scheibe N, Sosnowski N, Pinkhasik A, Vonderbank S, Bastian A - Int J Chron Obstruct Pulmon Dis (2015)

Sonografic measurement of the maximum lung movement.Notes: (A) Sonographic measurement of the up- and downward movement of the lung silhouette – here on the right side. E marks the lowest point of the lung silhouette at maximal end expiration. (B) Sonographic measurement of the up- and downward movement of the lung silhouette – here on the right side. E marks the lowest point of the lung silhouette at maximal end expiration, and I marks the lowest point at maximal inspiration. In this example, the distance between E and I is 28 mm.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4574853&req=5

f2-copd-10-1925: Sonografic measurement of the maximum lung movement.Notes: (A) Sonographic measurement of the up- and downward movement of the lung silhouette – here on the right side. E marks the lowest point of the lung silhouette at maximal end expiration. (B) Sonographic measurement of the up- and downward movement of the lung silhouette – here on the right side. E marks the lowest point of the lung silhouette at maximal end expiration, and I marks the lowest point at maximal inspiration. In this example, the distance between E and I is 28 mm.
Mentions: All participants were evaluated in a sitting position. Ultrasound was performed with a Hitachi ultrasound system (Sono MR, EUB-7500 HV) using a 3.5 MHz curved probe. The transducer was placed at the lowest part of the lung silhouette in the scapular line (Figure 1). The participant was instructed to exhale as deeply as possible (to RV) and then to inhale deeply to total lung capacity. This maneuver was filmed, and afterward, the distance between the highest and the lowest point of the lung silhouette was measured (Figure 2A and B). This maneuver was performed on the right and the left side. For comparison between this method and the anterior method, only the right side value was used because the anterior method was only used on the right side because of the well-known difficulties on the left side with the anterior method.20,21,24,27,29 The median value was calculated.

Bottom Line: Lung function parameters, blood gases, and 6-minute walk test were also collected and compared to the sonographic results.The sonographic measurement of the lung silhouette was easy to perform in all study participants.There was also a strong correlation between the demonstrated sonographic measurement of the up- and downward movement of the lung silhouette and the forced expiratory volume in the first second (r=0.83).

View Article: PubMed Central - PubMed

Affiliation: Department of Pneumonology, Marienkrankenhaus Kassel, Kassel, Germany.

ABSTRACT

Background: Diaphragmatic dysfunction is an important reason for dyspnea in COPD patients. But diaphragmatic dysfunction is difficult to evaluate. Ultrasound is an option. We measure sonographically the up- and downward movement of the lung silhouette on both hemidiaphragms. The aim of this prospective investigation was to compare this method with another sonographic method that visualizes the right hemidiaphragm directly and to compare the sonographic results with lung function parameters.

Methods and patients: Eighty participants - 20 healthy persons and 60 COPD patients - three groups each with 20 patients with COPD GOLD II, III, and IV - were investigated. The sonographic measurements of the diaphragms were performed. Lung function parameters, blood gases, and 6-minute walk test were also collected and compared to the sonographic results.

Results: The sonographic measurement of the lung silhouette was easy to perform in all study participants. The correlation between the sonographic methods measuring the right hemidiaphragmatic movement was strong (r=0.85). There was also a strong correlation between the demonstrated sonographic measurement of the up- and downward movement of the lung silhouette and the forced expiratory volume in the first second (r=0.83).

Conclusion: We demonstrated that the sonographic measurement of the movement of the lung silhouette is an easy way to establish diaphragmatic dysfunction in COPD patients; it can be done in all patients with reliable results for the right and the left hemidiaphragm.

No MeSH data available.


Related in: MedlinePlus