Changes in diaphragm thickness and 6-min walking distance improvement after inspiratory muscle training in patients with chronic obstructive pulmonary disease: Clinical trial

Ichiba, Tomomi; Miyagawa, Tetsuo; Tsuda, Toru; Kera, Takeshi; Yasuda, Osamu

doi:10.1016/j.heliyon.2023.e20079

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…In chronic patients, assessment of diaphragm excursion may be very useful for stratifying the severity of the disease, avoiding repeated spirometric examinations and completing the physiological assessment, also in order to modulate treatment. In this context, diaphragm ultrasound could also represent a useful tool for monitoring the response to inspiratory muscle training [ 97 , 110 , 111 ]. During acute exacerbations, on the other side, the evaluation of diaphragm thickness and thickening fraction could be useful to guide treatment, verify response to NIV and, eventually, decide to escalate oxygen and ventilatory support.…”

Section: Diaphragm Ultrasound In Specific Clinical Situations or Dise...mentioning

confidence: 99%

Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients

Siniscalchi,

Nouvenne,

Cerundolo

et al. 2024

Geriatrics

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Diaphragm muscle dysfunction is increasingly recognized as a fundamental marker of several age-related diseases and conditions including chronic obstructive pulmonary disease, heart failure and critical illness with respiratory failure. In older individuals with physical frailty and sarcopenia, the loss of muscle mass and function may also involve the diaphragm, contributing to respiratory dysfunction. Ultrasound has recently emerged as a feasible and reliable strategy to visualize diaphragm structure and function. In particular, it can help to predict the timing of extubation in patients undergoing mechanical ventilation in intensive care units (ICUs). Ultrasonographic evaluation of diaphragmatic function is relatively cheap, safe and quick and can provide useful information for real-time monitoring of respiratory function. In this review, we aim to present the current state of scientific evidence on the usefulness of ultrasound in the assessment of diaphragm dysfunction in different clinical settings, with a particular focus on older patients. We highlight the importance of the qualitative information gathered by ultrasound to assess the integrity, excursion, thickness and thickening of the diaphragm. The implementation of bedside diaphragm ultrasound could be useful for improving the quality and appropriateness of care, especially in older subjects with sarcopenia who experience acute respiratory failure, not only in the ICU setting.

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Section: Diaphragm Ultrasound In Specific Clinical Situations or Dise...mentioning

confidence: 99%

Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients

Siniscalchi,

Nouvenne,

Cerundolo

et al. 2024

Geriatrics

View full text Add to dashboard Cite

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Appropriate body position and site for diaphragm ultrasound: Comparison with inspiratory mouth pressure

Okada,

Kamiya,

Yanagi

et al. 2024

WFUMB Ultrasound Open

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Activity-related dyspnea and exercise intolerance in chronic obstructive pulmonary disease: recent insights

James,

Berton,

Neder

2024

Current Opinion in Pulmonary Medicine

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Purpose of review Exertional dyspnea and exercise intolerance remain key patient-related outcomes in chronic obstructive pulmonary disease (COPD). Improvement in treatment strategies is pendant further understand of their underpinnings across the spectrum of disease severity. Recent findings Emerging literature has been reviewed based on a conceptual framework that relates ventilatory demand to capacity under the modulating influence of sub-cortical and cortical centers (symptom perception and affective interpretation). Evidence supporting these fundamental tenets is critically appraised, focusing on mechanistic and interventional studies that shed novel light on the sources of heightened and/or mechanically constrained ventilation. Mechanistic studies using proxies of the inspiratory neural drive (e.g., diaphragm electromyography) were particularly informative, as well as interventional trials aimed at decreasing afferent stimulation and/or symptom perception via pharmacological (e.g., low-dose opiates in selected patients, high flow oxygen, oral nitrate) and nonpharmacological (e.g., novel exercise training paradigms, inspiratory muscle training, breathing techniques) interventions. Summary Therapeutic and rehabilitative strategies to lessen dyspnea's devastating impact on quality of life should minimize demand in the setting of reduced capacity and increased sensation awareness in COPD. The most successful attempts so far have amalgamated pharmacological and nonpharmacological approaches tailored to the main underlying mechanisms on an individual basis.

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Changes in diaphragm thickness and 6-min walking distance improvement after inspiratory muscle training in patients with chronic obstructive pulmonary disease: Clinical trial

Cited by 3 publications

References 29 publications

Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients

Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients

Appropriate body position and site for diaphragm ultrasound: Comparison with inspiratory mouth pressure

Activity-related dyspnea and exercise intolerance in chronic obstructive pulmonary disease: recent insights

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