Relationships between diaphragm ultrasound, spirometry, and respiratory mouth pressures in children

Rock, Kelly; Addison, Odessa; Marchese, Victoria

doi:10.1016/j.resp.2022.103950

Cited by 6 publications

(8 citation statements)

References 26 publications

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“…31,32 In addition, specifically in children, longer excursion time is also related to greater MIP likely because of more time allowed to generate volume. 22 Given that pulmonary infarcts are common in children with SCD, the increased thickening and excursion time might be explained by the need to recruit more alveoli at rest and during exercise. For the same reason, work of breathing is likely higher for a given amount of respiratory movement.…”

Section: Discussionmentioning

confidence: 99%

“…A mark was placed at the 8th intercostal space to denote the center of the measurement area. Images were obtained at the end of deep inspiration to total lung capacity (TLC) and quiet expiration to functional residual capacity (FRC) as previously described 22 . At the zone of apposition, the diaphragm is represented as a hypoechoic, fibrous layer between the diaphragmatic pleura and the peritoneal membrane (Figure 1A–B).…”

Section: Methodsmentioning

confidence: 99%

“…The ultrasound beam was directed cranially and dorsally to be perpendicular to the posterior third of the diaphragm. Images were obtained during quiet breaths (QB) to tidal volume, deep breaths (DB) to TLC, and maximal voluntary sniff maneuvers (SNF) via sharp inhalations through the nose as previously described 22 . In M‐mode, the diaphragm is represented as an echogenic tracing line that moves toward the transducer with inspiration (Figure 1C).…”

Section: Methodsmentioning

confidence: 99%

“…Images were obtained at the end of deep inspiration to total lung capacity (TLC) and quiet expiration to functional residual capacity (FRC) as previously described. 22 At the zone of apposition, the diaphragm is represented as a hypoechoic, fibrous layer between the diaphragmatic pleura and the peritoneal membrane (Figure 1A-B). Thickness was represented by the distance in mm from the middle of the diaphragmatic pleura to the middle of the peritoneal membrane.…”

Section: Diaphragm Ultrasonographymentioning

confidence: 99%

“…Images were obtained during quiet breaths (QB) to tidal volume, deep breaths (DB) to TLC, and maximal voluntary sniff maneuvers (SNF) via sharp inhalations through the nose as previously described. 22 In M-mode, the diaphragm is represented as an echogenic tracing line that moves toward the transducer with inspiration (Figure 1C). Excursion in mm and time in s were measured while tracking the movement of the time-motion tracing line from baseline to peak position during inspiration.…”

Section: Diaphragm Ultrasonographymentioning

confidence: 99%

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Diaphragm excursion correlates with performance and ventilation on the 6‐min walk test in children with sickle cell disease

Rock

Marchese

2023

Pediatric Pulmonology

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Introduction: Diaphragm function may be impaired in children with sickle cell disease (SCD). We hypothesized that diaphragm function is related to performance and ventilation on the 6-min walk test (6MWT).Methods: Respiratory muscle testing, diaphragm ultrasonography, and the 6MWT with portable gas analysis were performed on children with SCD and age-and sex-matched controls.Results: Fourteen children with SCD were enrolled. Comparisons were made between nine children with SCD (9.89 ± 2.93 years) and nine controls (10.33 ± 2.35 years). Diaphragm thickness at total lung capacity, thickening fraction, and excursion time during quiet breaths and deep breaths (DB), all normalized by forced vital capacity, were greater in children with SCD (p< 0.05 for all). 6MWT distance was shorter in children with SCD (450.87 ± 74.2 m vs. 579.22 ± 72.46 m, p = 0.01). Tidal volume (V T ), minute ventilation (V E ̇), and oxygen consumption (V O2 ̇) were also lower (p< 0.05 for all). DB excursion correlated positively with 6MWT distance (r = 0.648, p = 0.023) and negatively with rate of perceived exertion (RPE) (r = −0.759, p = 0.003). RPE correlated negatively with distance (r = −0.680, p = 0.015). DB excursion time correlated positively with distance (r = 0.611, p = 0.035), V T (r = 0.770, p = 0.009), V E ̇(r = 0.736, p = 0.015), and V O2 ̇(r = 0.751, p = 0.012).Conclusions: Increased diaphragm excursion may be a strategy used to relieve air hunger while longer excursion time may reflect compensations to increase lung recruitment. Further studies are needed to better understand how these mechanisms affect exercise tolerance in children with SCD.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Diaphragm Ultrasonographymentioning

confidence: 99%

Section: Diaphragm Ultrasonographymentioning

confidence: 99%

See 3 more Smart Citations

Diaphragm excursion correlates with performance and ventilation on the 6‐min walk test in children with sickle cell disease

Rock

Marchese

2023

Pediatric Pulmonology

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Relationship Between Diaphragm Thickness, Thickening Fraction, Dome Excursion, and Respiratory Pressures in Healthy Subjects: An Ultrasound Study

Yamada,

Minami,

Yoshino

et al. 2024

Lung

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Purpose Diaphragm ultrasonography is used to identify causes of diaphragm dysfunction. However, its correlation with pulmonary function tests, including maximal inspiratory (MIP) and expiratory pressures (MEP), remains unclear. This study investigated this relationship by measuring diaphragm thickness, thickening fraction (TF), and excursion (DE) using ultrasonography, and their relationship to MIP and MEP. It also examined the influence of age, sex, height, and BMI on these measures. Methods We recruited healthy Japanese volunteers and conducted pulmonary function tests and diaphragm ultrasonography in a seated position. Diaphragm ultrasonography was performed during quiet breathing (QB) and deep breathing (DB) to measure the diaphragm thickness, TF, and DE. A multivariate analysis was conducted, adjusting for age, sex, height, and BMI. Results Between March 2022 and January 2023, 109 individuals (56 males) were included from three facilities. The mean (standard deviation) MIP and MEP [cmH2O] were 72.2 (24.6) and 96.9 (35.8), respectively. Thickness [mm] at the end of expiration was 1.7 (0.4), TF [%] was 50.0 (25.9) during QB and 110.7 (44.3) during DB, and DE [cm] was 1.7 (0.6) during QB and 4.4 (1.4) during DB. Multivariate analysis revealed that only DE (DB) had a statistically significant relationship with MIP and MEP (p = 0.021, p = 0.008). Sex, age, and BMI had a statistically significant influence on relationships between DE (DB) and MIP (p = 0.008, 0.048, and < 0.001, respectively). Conclusion In healthy adults, DE (DB) has a relationship with MIP and MEP. Sex, age, and BMI, but not height, are influencing factors on this relationship.

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Diaphragmatic and excursion thickness in newborns using diaphragmatic kinesiology ultrasound: an observational study

Andreazza,

Binotto,

Cavalcante da Silva

et al. 2024

Fisioter. mov.

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Introduction The study of the diaphragm muscle has aroused the interest of physiotherapists who work with kinesiological ultrasonography, but still little explored; however, its findings can contribute to the clinical practice of hospitalized patients in neonatal intensive care units. Objective To measure the excursion and thickening of the diaphragm and describe measurements among neonates, preterm, and full-term. Methods Diaphragmatic kinesiological ultrasonography was performed on hospitalized newborns, in Neonatal Unit Care Unit, placed in supine position in their own bed, on the sixth day of life. Three repeated measurements of the same respiratory cycle were made, both for excursion and for diaphragmatic thickening. Results 37 newborns participated in the study and 25 were premature. The mean weight at the time of collection was 2,307.0 ± 672.76 grams and the gestational age was 35.7 ± 3.3 weeks. Diaphragmatic excursion increased with increasing gestational age (p = 0.01, df = 0.21) in term infants (p = 0.17, df = 0.35). Conclusion There was a positive correlation between diaphragmatic excursion and gestational age. There was no statistically significant difference in the measurements of excursion and inspiratory diaphragm thickening between preterm and term newborns, although pointing to higher measurements in the latter group.

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Relationships between diaphragm ultrasound, spirometry, and respiratory mouth pressures in children

Cited by 6 publications

References 26 publications

Diaphragm excursion correlates with performance and ventilation on the 6‐min walk test in children with sickle cell disease

Diaphragm excursion correlates with performance and ventilation on the 6‐min walk test in children with sickle cell disease

Relationship Between Diaphragm Thickness, Thickening Fraction, Dome Excursion, and Respiratory Pressures in Healthy Subjects: An Ultrasound Study

Diaphragmatic and excursion thickness in newborns using diaphragmatic kinesiology ultrasound: an observational study

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