Imaging of the Diaphragm Following Cardiac Surgery: Focus on Ultrasonographic Assessment

Abstract

Diaphragm dysfunction is a common complication following cardiac surgery. Its clinical impact is variable, ranging from the absence of symptoms to the acute respiratory failure. Post‐operative diaphragm dysfunction may negatively affect patients' prognosis delaying the weaning from the mechanical ventilation (MV), extending the time of hospitalization and increasing mortality. Ultrasonography is a valid tool to evaluate diaphragmatic impairment in different settings, like the Intensive Care Unit, to predict successful weaning from the MV, and the Cardiovascular Rehabilitation Unit, to stratify patients in terms of risk of functional recovery failure. The aim of this review is to describe the pathophysiology of post‐cardiac surgery diaphragm dysfunction, the techniques used for its diagnosis and the potential applications of diaphragm ultrasound.

Pericardial Adhesion and Chronic Non-Specific Neck Pain following Thoracentesis: An Osteopathic Approach

“…CABG is not free from dangers and complications during and after surgery, which can range from surgical site infection to the appearance of arrhythmias, up to the event of a periprocedural AMI and pleural effusion [8]. The phrenic nerve can undergo a transient or permanent injury (up to a maximum of 75% of patients), with an ipsilateral elevation of the diaphragm, or, in the most severe cases, both domes are dysfunctional [9]. The intercostal nerves undergo a structural and functional alteration of the myelin and meningeal layers, and the appearance of fibrosis [10].…”