Ultrasonographic evaluation of diaphragmatic thickness and movement for assessment of diaphragmatic dysfunction in COPD patients

Abstract

Abstract Backgrounds Chronic obstructive pulmonary disease (COPD) is often ascribed to the disparity that exists between ventilatory loading and diaphragmatic function. The principal factor contributing to this imbalance is the mechanical difficulties brought about by pulmonary hyperinflation. This causes the fiber lengths of the respiratory muscles to be suboptimal, thereby decreasing the tension generated. The frailty of the respiratory musculature is further exacerbated by hypercapnia, acidosis, nutritional deficiency, and steroid therapy. As the principal respiratory muscle, the diaphragm is responsible for 75% of quiescent lung ventilation. Ultrasonography has exhibited substantial promise in evaluating the effectiveness of the diaphragm. The goal of the research was to assess the diaphragmatic function in COPD patients using ultrasonographic examination and to study its correlation with pulmonary function tests. Methods This work was performed on 60 individuals with COPD and 20 healthy volunteers (control group). All the subjects were sequentially examined by chest X-ray and spirometry in one time and then repeated 15–45 min after the first dose of inhalation therapy (salbutamol); then, 6MWT, ABG, and ultrasonography were done for all patients. Results In COPD patients, diaphragmatic thickness and excursion were substantially reduced in comparison to the control group; these parameters were also significantly correlated with pulmonary function tests. Conclusions A reduction in diaphragmatic thickness and excursion is observed in patients diagnosed with COPD.

Keywords

• Chronic obstructive pulmonary disease
• Diaphragmatic thickness
• Diaphragmatic movement