Contractile capability of the diaphragm assessed by ultrasonography predicts nocturnal oxygen saturation in COPD

Abstract

This study suggested a close relationship between the NSpO and the contractile capability of the diaphragm assessed by ultrasonography in COPD. The %ΔTdi combined with PaO might predict NSpO in COPD patients with mild or no daytime hypoxaemia.

Diaphragmatic Thickness Fraction in Subjects at High-Risk for COPD Exacerbations

“…8,9 Diaphragmatic thickness fraction measurements have been reported to be useful in determination of lung hyperinflation in subjects with COPD. 10,11 Ultrasoundbased diaphragmatic thickness fraction measurements have been reported to be useful in determination of lung hyperinflation in subjects with COPD. 10,11 In addition, diaphragmatic thickness fraction has been successfully used for predicting the outcome of weaning and extubation in subjects admitted to the ICU as well as in determining the respiratory effort and the contractile activity of the diaphragm.…”

“…10,11 Ultrasoundbased diaphragmatic thickness fraction measurements have been reported to be useful in determination of lung hyperinflation in subjects with COPD. 10,11 In addition, diaphragmatic thickness fraction has been successfully used for predicting the outcome of weaning and extubation in subjects admitted to the ICU as well as in determining the respiratory effort and the contractile activity of the diaphragm. 9,[12][13][14][15] Therefore, it may be a potential tool for the assessment of disease status and outcomes in patients with COPD.…”

Year in review 2017: Chronic obstructive pulmonary disease and asthma

“…used non‐invasive bedside ultrasound during COPD exacerbations to detect diagrammatic dysfunction (DD) that was related to failure of non‐invasive ventilation (NIV) and hospital mortality. Similarly, Okura et al . found that even in non‐hypercapnic, stable COPD patients, DD was related to severity of nocturnal O 2 desaturations, so these patients may be at risk to develop frank ventilatory failure.…”

“…Antenora et al 37 used non-invasive bedside ultrasound during COPD exacerbations to detect diagrammatic dysfunction (DD) that was related to failure of non-invasive ventilation (NIV) and hospital mortality. Similarly, Okura et al 38 found that even in non-hypercapnic, stable COPD patients, DD was related to severity of nocturnal O 2 desaturations, so these patients may be at risk to develop frank ventilatory failure. In their editorial, Lopez-Campos et al 39 reviewed recent advances in instituting high-pressure nocturnal NIV during stable phase COPD, and described the mechanisms which might account for its beneficial effects.…”

“…(B) Thickness of the diaphragm at the end of maximal inspiration or total lung capacity (Tdi TLC ). Tdi was imaged as the non-echogenic muscular layer outlined by the membranes of the peritoneum and diaphragmatic pleura, each imaged as an echogenic line (Reproduced from Okura et al,38 with permission).…”