Interpreting diaphragmatic movement with bedside imaging, review article

Haji, Kavi; Royse, Alistair; Green, Cameron; Botha, John; Canty, David; Royse, Colin

doi:10.1016/j.jcrc.2016.03.006

Cited by 44 publications

(48 citation statements)

References 74 publications

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“…Other clinical effects of diaphragmatic dysfunction may include rapid shallow breathing, paradoxical inward movement of the abdomen on inspiration, recurrent pulmonary infection, restrictive pattern on lung function test, and hemidiaphragm elevation on chest radiography . Moreover, diaphragmatic dysfunction is recognized as an important cause for increased respiratory load . Its prompt recognition is important in order to diagnose impending respiratory failure when clinical symptoms are still borderline.…”

Section: Discussionmentioning

confidence: 99%

“…42,43 Moreover, diaphragmatic dysfunction is recognized as an important cause for increased respiratory load. [44][45][46] Its prompt recognition is important in order to diagnose impending respiratory failure when clinical symptoms are still borderline. Therefore, an accurate and rapid assessment of the diaphragm is a potentially useful tool for clinicians 46 especially in emergency settings.…”

mentioning

confidence: 99%

“…[44][45][46] Its prompt recognition is important in order to diagnose impending respiratory failure when clinical symptoms are still borderline. Therefore, an accurate and rapid assessment of the diaphragm is a potentially useful tool for clinicians 46 especially in emergency settings. This is particularly useful if we consider the described subjectivity of the most used clinical parameters in the evaluation of bronchiolitis in the ED.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Point of care diaphragm ultrasound in infants with bronchiolitis: A prospective study

Buonsenso

Supino

Giglioni

et al. 2018

Pediatric Pulmonology

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Point of care diaphragm ultrasound in infants with bronchiolitis: A prospective study

Buonsenso

Supino

Giglioni

et al. 2018

Pediatric Pulmonology

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“…A standardized and comprehensive approach to evaluate diaphragm function by means of diaphragm ultrasound was used and based upon previous diaphragm ultrasound studies . A portable ultrasound machine (LOGIQ S8‐XD clear, GE Healthcare, London, UK) with a 3.5 MHz convex transducer was used for assessment of diaphragm excursions in the subcostal view, and a 10 MHz linear transducer was used for evaluation of diaphragm thickness in the zone of apposition.…”

Section: Methodsmentioning

confidence: 99%

“…A standardized and comprehensive approach to evaluate diaphragm function by means of diaphragm ultrasound was used and based upon previous diaphragm ultrasound studies. 22,[33][34][35][36] Figure S1A). Diaphragm excursion amplitude was assessed during tidal breathing ( Figure S1A), at TLC, and following a voluntary sniff maneuver.…”

Section: Diaphragm Ultrasoundmentioning

confidence: 99%

Phrenic nerve involvement and respiratory muscle weakness in patients with Charcot‐Marie‐Tooth disease 1A

Spießhoefer

Henke

Kabitz

et al. 2019

J Peripheral Nervous Sys

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Diaphragm weakness in Charcot‐Marie‐Tooth disease 1A (CMT1A) is usually associated with severe disease manifestation. This study comprehensively investigated phrenic nerve conductivity, inspiratory and expiratory muscle function in ambulatory CMT1A patients. Nineteen adults with CMT1A (13 females, 47 ± 12 years) underwent spiromanometry, diaphragm ultrasound, and magnetic stimulation of the phrenic nerves and the lower thoracic nerve roots, with recording of diaphragm compound muscle action potentials (dCMAP, n = 15), transdiaphragmatic and gastric pressures (twPdi and twPgas, n = 12). Diaphragm motor evoked potentials (dMEP, n = 15) were recorded following cortical magnetic stimulation. Patients had not been selected for respiratory complaints. Disease severity was assessed using the CMT Neuropathy Scale version 2 (CMT‐NSv2). Healthy control subjects were matched for age, sex, and body mass index. The following parameters were significantly lower in CMT1A patients than in controls (all P < .05): forced vital capacity (91 ± 16 vs 110 ± 15% predicted), maximum inspiratory pressure (68 ± 22 vs 88 ± 29 cmH2O), maximum expiratory pressure (91 ± 23 vs 123 ± 24 cmH2O), and peak cough flow (377 ± 135 vs 492 ± 130 L/min). In CMT1A patients, dMEP and dCMAP were delayed. Patients vs controls showed lower diaphragm excursion (5 ± 2 vs 8 ± 2 cm), diaphragm thickening ratio (DTR, 1.9 [1.6‐2.2] vs 2.5 [2.1‐3.1]), and twPdi (8 ± 6 vs 19 ± 7 cmH2O; all P < .05). DTR inversely correlated with the CMT‐NSv2 score (r = −.59, P = .02). There was no group difference in twPgas following abdominal muscle stimulation. Ambulatory CMT1A patients may show phrenic nerve involvement and reduced respiratory muscle strength. Respiratory muscle weakness can be attributed to diaphragm dysfunction alone. It relates to neurological impairment and likely reflects a disease continuum.

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Number of attempts required by emergency physicians to achieve competency in diaphragmatic ultrasound imaging

Puchongmart

Nakornchai

Rittayamai

et al. 2021

J of Clinical Ultrasound

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Purpose: This research aimed to determine the number of attempts that emergency physicians need to become proficient in undertaking diaphragmatic ultrasound imaging.Methods: A prospective observational study was conducted at the emergency department (ED) of a tertiary-care university hospital. Sixteen emergency physicians were each required to obtain a set of images of the right hemidiaphragm of five dyspneic patients using both diaphragmatic excursion and thickness techniques. The images were subsequently reviewed by a specialist using American College of Emergency Physician guidelines. If the evaluations of a physician did not reach the expected standard, the physician was to be given feedback and requested to collect images from another five patients. The process was to be repeated until such time as the images obtained by the physician were deemed to be up to standard.Results: Eighty patients, twelve emergency medicine residents, and four attending physicians were enrolled. Following a didactic session on diaphragmatic ultrasound imaging and its interpretation, practicing on five patients proved sufficient to achieve an adequate level of competency in conducting diaphragmatic ultrasound examinations. Conclusion:Practicing on five patients is sufficient for emergency physicians to achieve an adequate level of competency in conducting right-sided diaphragmatic ultrasound examinations.

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Interpreting diaphragmatic movement with bedside imaging, review article

Cited by 44 publications

References 74 publications

Point of care diaphragm ultrasound in infants with bronchiolitis: A prospective study

Point of care diaphragm ultrasound in infants with bronchiolitis: A prospective study

Phrenic nerve involvement and respiratory muscle weakness in patients with Charcot‐Marie‐Tooth disease 1A

Number of attempts required by emergency physicians to achieve competency in diaphragmatic ultrasound imaging

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