Usefulness of Diaphragm Ecointensity for the Management of Patients With Amyotrophic Lateral Sclerosis

Pearls and pitfalls of respiratory testing in a patient with amyotrophic lateral sclerosis and COPD

“…For example, a peak cough flow of 200 L·min −1 could be associated with a diaphragmatic expiratory excursion ranging from about 2 cm to about 5 cm. In a preliminary study of 24 patients with ALS, F errer E spinosa et al [ 27 ] reported that diaphragm echo intensity was greater in patients on NIV than in patients not on NIV. A major limitation of this technique is that within the diaphragm there is often an additional bright layer due to connective tissue and vessels ( figure 2 ) that is bound to increase echo intensity independent of any ALS-associated change in muscle fibres.…”