Littérature scientifique sur le sujet « Diaphragm ultrasonography »
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Articles de revues sur le sujet "Diaphragm ultrasonography"
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Sembera, Martin, Andrew Busch, Alena Kobesova, Barbora Hanychova, Jan Sulc et Pavel Kolar. « Postural-respiratory function of the diaphragm assessed by M-mode ultrasonography ». PLOS ONE 17, no 10 (10 octobre 2022) : e0275389. http://dx.doi.org/10.1371/journal.pone.0275389.
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Objectives The diaphragm changes position and respiratory excursions during postural loading. However, it is unclear how it reacts to lifting a load while breath-holding or breathing with simultaneous voluntary contraction of the abdominal muscles (VCAM). This study analyzed diaphragm motion in healthy individuals during various postural-respiratory situations. Methods 31 healthy participants underwent examination of the diaphragm using M-mode ultrasonography, spirometry, and abdominal wall tension (AWT) measurements. All recordings were performed simultaneously during three consecutive scenarios, i.e., 1. Lifting a load without breathing; 2. Lifting a load and breathing naturally; 3. Lifting a load and breathing with simultaneous VCAM. Results Using paired-samples t-tests, lifting a load without breathing displaced the diaphragm’s expiratory position more caudally (P < .001), with no change noted in the inspiratory position (P = .373). During lifting a load breathing naturally, caudal displacement of the diaphragm’s inspiratory position was presented (P < .001), with no change noted in the expiratory position (P = 0.20) compared to tidal breathing. Total diaphragm excursion was greater when loaded (P = .002). Lifting a load and breathing with VCAM demonstrated no significant changes in diaphragm position for inspiration, expiration, or total excursion compared to natural loaded breathing. For all scenarios, AWT measures were greater when lifting a load (P < .001). Conclusion In healthy individuals, caudal displacement and greater excursions of the diaphragm occurred when lifting a load. The postural function of the diaphragm is independent of its respiratory activity and is not reduced by the increase in AWT.
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Mele, Antonietta, Paola Mantuano, Adriano Fonzino, Francesco Rana, Roberta Francesca Capogrosso, Francesca Sanarica, Jean-Francois Rolland, Ornella Cappellari et Annamaria De Luca. « Ultrasonography validation for early alteration of diaphragm echodensity and function in the mdx mouse model of Duchenne muscular dystrophy ». PLOS ONE 16, no 1 (12 janvier 2021) : e0245397. http://dx.doi.org/10.1371/journal.pone.0245397.
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The mdx mouse model of Duchenne muscular dystrophy is characterized by functional and structural alterations of the diaphragm since early stages of pathology, closely resembling patients’ condition. In recent years, ultrasonography has been proposed as a useful longitudinal non-invasive technique to assess mdx diaphragm dysfunction and evaluate drug efficacy over time. To date, only a few preclinical studies have been conducted. Therefore, an independent validation of this method by different laboratories is needed to increase results reliability and reduce biases. Here, we performed diaphragm ultrasonography in 3- and 6-month-old mdx mice, the preferred age-window for pharmacology studies. The alteration of diaphragm function over time was measured as diaphragm ultrasound movement amplitude. At the same time points, a first-time assessment of diaphragm echodensity was performed, as an experimental index of progressive loss of contractile tissue. A parallel evaluation of other in vivo and ex vivo dystrophy-relevant readouts was carried out. Both 3- and 6-month-old mdx mice showed a significant decrease in diaphragm amplitude compared to wild type (wt) mice. This index was well-correlated either with in vivo running performance or ex vivo isometric tetanic force of isolated diaphragm. In addition, diaphragms from 6-month-old dystrophic mice were also highly susceptible to eccentric contraction ex vivo. Importantly, we disclosed an age-dependent increase in echodensity in mdx mice not observed in wt animals, which was independent from abdominal wall thickness. This was accompanied by a notable increase of pro-fibrotic TGF-β1 levels in the mdx diaphragm and of non-muscle tissue amount in diaphragm sections stained by hematoxylin & eosin. Our findings corroborate the usefulness of diaphragm ultrasonography in preclinical drug studies as a powerful tool to monitor mdx pathology progression since early stages.
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Endo, Yoshimi. « Diaphragm Dysfunction Assessed by Ultrasonography ». Ultrasound Quarterly 28, no 2 (juin 2012) : 128. http://dx.doi.org/10.1097/01.ruq.0000415528.67128.9c.
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Liu, Xiaoman, Qingming Qu, Panmo Deng, Yuehua Zhao, Chenghong Liu, Conghui Fu et Jie Jia. « Assessment of Diaphragm in Hemiplegic Patients after Stroke with Ultrasound and Its Correlation of Extremity Motor and Balance Function ». Brain Sciences 12, no 7 (4 juillet 2022) : 882. http://dx.doi.org/10.3390/brainsci12070882.
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Background: A variety of functional disorders can be caused after stroke, among which impairment of respiratory function is a frequent and serious complication of stroke patients. The aim of this study was to examine diaphragmatic function after stroke by diaphragm ultrasonography and then to apply to explore its correlation with extremity motor function and balance function of the hemiplegia patients. Methods: This cross-sectional observational study recruited 48 hemiplegic patients after stroke and 20 matched healthy participants. The data of demographic and ultrasonographic assessment of all healthy subjects were recorded, and 45 patients successfully underwent baseline data assessment in the first 48 h following admission, including post-stroke duration, stroke type, hemiplegia side, pipeline feeding, pulmonary infection, ultrasonographic assessment for diaphragm, Fugl–Meyer Motor Function Assessment Scale (FMA Scale), and Berg Balance Scale assessment. Ultrasonographic assessment parameters included diaphragm mobility under quiet and deep breathing, diaphragm thickness at end-inspiratory and end-expiratory, and calculated thickening fraction of the diaphragm. The aim was to analyze the diaphragm function of hemiplegic patients after stroke and to explore its correlation with extremity motor function and balance function. Results: The incidence of diaphragmatic dysfunction under deep breath was 46.67% in 45 hemiplegia patients after stroke at the convalescent phase. The paralyzed hemidiaphragm had major impairments, and the mobility of the hemiplegic diaphragm was significantly reduced during deep breathing (p < 0.05). Moreover, the thickness fraction of hemiplegic side was extremely diminished when contrasted with the healthy control and non-hemiplegic side (p < 0.05). We respectively compared the diaphragm mobility under deep breath on the hemiplegic and non-hemiplegic side of patients with left and right hemiplegia and found there was no significant difference between the hemiplegic side of right and left hemiplegia (p > 0.05), but the non-hemiplegic side of right hemiplegia was significantly weaker than that of left hemiplegia patients (p < 0.05). The diaphragm mobility of stroke patients under quiet breath was positively correlated with age and FMA Scale score (R2 = 0.296, p < 0.05), and significant positive correlations were found between the diaphragm mobility under deep breath and Berg Balance Scale score (R2 = 0.11, p < 0.05), diaphragm thickness at end-inspiratory and FMA Scale score (R2 = 0.152, p < 0.05), and end-expiratory thickness and FMA Scale score (R2 = 0.204, p < 0.05). Conclusions: The mobility and thickness fraction of the hemiplegic diaphragm after stroke by diaphragm ultrasonography were significantly reduced during deep breathing. Diaphragm mobility on bilateral sides of the right hemiplegia patients were reduced during deep breathing. Moreover, the hemiplegic diaphragmatic function was positively correlated with extremity motor and balance function of the hemiplegia patients.
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Ahsan, Md Qumrul, Arni Das et Tahmina Banu. « Prenatal Diagnosis of Prepyloric Diaphragm : A Case Report ». Chattagram Maa-O-Shishu Hospital Medical College Journal 18, no 2 (24 juin 2020) : 67–69. http://dx.doi.org/10.3329/cmoshmcj.v18i2.47780.
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The prepyloric diaphragm (A type of pyloric atresia) is a rare type of congenital malformation of gastrointestinal tract of unknown etiology. A thin two layered mucus membrane of about 2 to 4 mm, proximal to pylorus causes the gastric outlet obstruction in neonate. We are reporting a case of prepyloric diaphragm which had been diagnosed at 37 weeks of gestation by Ultrasonography and diagnosis was confirmed after birth during surgery. Prenatal ultrasonography of a 37 weeks pregnant mother revealed polyhydramnios, persistently dilated, a fluid filled blind sac at epigastrium and right hypochondrium with peristaltic wave and to & fro movements of fluid contents. There was no double bubble sign. The baby boy was born by Caesarean Section. After breast feeding, baby had non-bilious vomiting with mild abdominal distension. Postnatal ultrasonography showed dilated fluid filled stomach. Exploratory laparotomy on 14thday of life revealed a prepyloric diaphragm with a central hole, 1 cm proximal to the pylorus. The 2 mm thick diaphragm was excised circumferentially. Postoperative period was uneventful. Milk feeding started at 6th post-operative day and discharged with advice at 7th post-operative day. Prepyloric diaphragm or antral web is to be considered as provisional diagnosis if there is prenatal suspicion of gastric outlet obstruction, polyhydramnios of mother and persistent non-bilious vomiting in neonate; as simple excision of the diaphragm is curative for this unusual abnormality if there is no other associated abnormality.
Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 67-69
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Perez, Alicia Martin, Samuel Fernández-Carnero, Cristina Sicilia-Gomez-de-Parada, Nicolas Cuenca-Zaldívar, Fermin Naranjo-Cinto, Daniel Pecos-Martín, Tomás Gallego-Izquierdo et Susana Nuñez-Nagy. « Diaphragmatic Activation Correlated with Lumbar Multifidus Muscles and Thoracolumbar Fascia by B-Mode and M-Mode Ultrasonography in Subjects with and without Non-Specific Low Back Pain : A Pilot Study ». Medicina 59, no 2 (8 février 2023) : 315. http://dx.doi.org/10.3390/medicina59020315.
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Background and Objectives: The diaphragm, the lumbar multifidus muscles, and the thoracolumbar fascia (TLF) execute an important role in the stability of the lumbar spine and their morphology has been modified in subjects with non-specific low back pain (NS-LBP). While it is true that three structures correlate anatomically, the possible functional correlation between them has not been investigated previously in healthy subjects nor in subjects with NS-LBP. The aim of the present study was to examine this functional nexus by means of a comparison based on ultrasonographic parameters of the diaphragm, the lumbar multifidus muscles, and the TLF in subjects with and without NS-LBP. Materials and Methods: A sample of 54 (23 NS-LBP and 31 healthy) subjects were included in the study. The thickness and diaphragmatic excursion at tidal volume (TV) and force volume (FV), the lumbar multifidus muscles thickness at contraction and at rest, and the TLF thickness were evaluated using rehabilitative ultrasound imaging (RUSI) by B-mode and M-mode ultrasonography. The diaphragm thickening capacity was also calculated by thickening fraction (TF) at tidal volume and force volume. Results: There were no significant differences recorded between the activation of the diaphragm and the activation of the lumbar multifidus muscles and TLF for each variable, within both groups. However, there were significant differences recorded between both groups in diaphragm thickness and diaphragm thickening capacity at tidal volume and force volume. Conclusions: Diaphragmatic activation had no functional correlation with the activation of lumbar multifidus muscles and TLF for both groups. Nevertheless, subjects with NS-LBP showed a reduced diaphragm thickness and a lower diaphragm thickening capacity at tidal volume and force volume, compared to healthy subjects.
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Lewińska, Agnieszka, et Karen Shahnazaryan. « The Use of Diaphragm Ultrasonography in Pulmonary Physiotherapy of COPD Patients : A Literature Review ». Journal of Clinical Medicine 9, no 11 (31 octobre 2020) : 3525. http://dx.doi.org/10.3390/jcm9113525.
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There is potentially a broad range of patient populations in which ultrasound imaging (US) might be beneficial form of physiotherapy process support. Among them, the group of patients with chronic obstructive pulmonary disease (COPD) is of great importance, as in this individuals the diaphragm dysfunction is frequently observed. Pulmonary physiotherapy often includes techniques which are intended to influence the diaphragm muscle but its anatomy does not allow for variety of techniques to assess function. Lack of easily available and reliable measures complicates outcomes interpretation and makes decision-making process difficult. A review of the electronic literature was conducted to identify studies related to the US assessment of physiotherapy process and its outcome in COPD patients. As a consequence, seven papers were identified. Based on the results obtained, it can be concluded that the diaphragm excursion is US measure that is most often described in context of diaphragm-related physiotherapy in COPD patients. The methodology applied, however, varies greatly making it difficult to compare results. Thus, developing standards of outcome assessment methods and therapy monitoring systems which are supported by evidence should be of paramount importance. Future studies could also focus on identifying which components of physiotherapeutic diaphragm-targeted approach provide acceptable level of evidence.
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ALTINKAYA ÇAVUŞ, Mine, Şerife GÖKBULUT BEKTAŞ, Hilal SİPAHİOĞLU, Gözde ERTÜRK ZARARSIZ et Sema TURAN. « Diyafram ultrasonografisinin weaning başarısını tahmin etmedeki gücü ». Cukurova Medical Journal 47, no 2 (30 juin 2022) : 747–55. http://dx.doi.org/10.17826/cumj.1037159.
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Amaç: Bu çalışmada amaç; diyafram kalınlığının weaning üzerine etkilerini ultrasonografi (USG) ile değerlendirmektir.
Gereç ve Yöntem: Prospektif olarak yapılan bu çalışmada; hastaların demografik özellikleri, yoğun bakıma yatış ve mekanik ventilasyon endikasyonları, ek hastalıkları, diyafram kalınlığı, Sıralı Organ Yetmezliği Değerlendirmesi (SOFA) skoru ve Basitleştirilmiş Akut Fizyoloji Skoru (SAPS) II, mortalite oranı, periferik oksijen satürasyonu (SpO2), IMV süresi, dakika hacmi, solunum sayısı (RR), ekspiratuar hacimleri, RSBI değerleri kaydedildi.Hastalar invaziv mekanik ventilatör (IMV) basınç desteği (PS) modunda 30 dakika boyunca spontan olarak ventile edildi . Diyafram kalınlığı (DT), B moduna ayarlanmış 7-10 MHz lineer ultrason probu kullanılarak ölçüldü. Sağ hemidiyafram, 8. ve 10. interkostal boşluklar arasındaki midaksiller çizgide diyafram ve göğüs kafesinin birleştiği bölgede görüntülendi. Ölçümler sonrasında hastalar stabil hale geldikten sonra 1 saat boyunca T-tüpe alındı. T-tüpte spontan solunum denemeleri (SBT)'ni başarıyla tamamlayan hastalar ekstübe edildi. Hastalar başarılı ve başarısız weaning olmak üzere 2 gruba ayrıldı.
Bulgular: Toplam 72 hasta çalışmaya dahil edilme kriterlerini sağlayarak değerlendirilmeye alındı. Hastaların 4 tanesi 24 saatten daha kısa süre IMV desteği aldığı için çalışma dışı bırakıldı. Diyafram kalınlık indeksi (DTI) ve diyafram kalınlaşma fraksiyonu (DTF) oranlarında gruplar arasında bir farklılık gözlenmedi. İnspirasyon sonunu diyafram kalınlığı (DTV) ve ekspirasyon sonunu diyafram kalınlığı (DFRV) olarak tanımlanan diyaframın kalınlık ölçümleri başarılı weaning grubunda daha yüksekti. Weaning başarısını tahmin etmek için DTV'nin en iyi eşik değeri 0.72, DFRV değeri 0.669 olarak bulundu.
Sonuç: Weaning başarısı diyafram fonksiyonları, diyafram kalınlık parametreleri ve akciğer kapasiteleri ile yakından ilişkilidir. USG, diyaframı değerlendirmek için kullanılabilecek pratik, hasta başı uygulanabilen, noninvaziv bir yöntemdir. DTV ve DFRV weaning sürecinde başarıyı tahmin edebilecek parametreler arasındadır. DTF ve DTI weaning başarısını öngörmede yetersiz bulundu.
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Criner, Gerard J. « Measuring diaphragm shortening using ultrasonography to predict extubation success ». Thorax 69, no 5 (12 avril 2014) : 402–4. http://dx.doi.org/10.1136/thoraxjnl-2013-204920.
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Kocis, Keith C., Peter J. Radell, Wayne I. Sternberger, Jane E. Benson, Richard J. Traystman et David G. Nichols. « Ultrasound evaluation of piglet diaphragm function before and after fatigue ». Journal of Applied Physiology 83, no 5 (1 novembre 1997) : 1654–59. http://dx.doi.org/10.1152/jappl.1997.83.5.1654.
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Kocis, Keith C., Peter J. Radell, Wayne I. Sternberger, Jane E. Benson, Richard J. Traystman, and David G. Nichols. Ultrasound evaluation of piglet diaphragm function before and after fatigue. J. Appl. Physiol. 83(5): 1654–1659, 1997.—Clinically, a noninvasive measure of diaphragm function is needed. The purpose of this study is to determine whether ultrasonography can be used to 1) quantify diaphragm function and 2) identify fatigue in a piglet model. Five piglets were anesthetized with pentobarbital sodium and halothane and studied during the following conditions: 1) baseline (spontaneous breathing); 2) baseline + CO2 [inhaled CO2 to increase arterial[Formula: see text] to 50–60 Torr (6.6–8 kPa)]; 3) fatigue + CO2 (fatigue induced with 30 min of phrenic nerve pacing); and 4) recovery + CO2 (recovery after 1 h of mechanical ventilation). Ultrasound measurements of the posterior diaphragm were made (inspiratory mean velocity) in the transverse plane. Images were obtained from the midline, just inferior to the xiphoid process, and perpendicular to the abdomen. M-mode measures were made of the right posterior hemidiaphragm in the plane just lateral to the inferior vena cava. Abdominal and esophageal pressures were measured and transdiaphragmatic pressure (Pdi) was calculated during spontaneous (Sp) and paced (Pace) breaths. Arterial blood gases were also measured. Pdi(Sp) and Pdi(Pace) during baseline + CO2 were 8 ± 0.7 and 49 ± 11 cmH2O, respectively, and decreased to 6 ± 1.0 and 27 ± 7 cmH2O, respectively, during fatigue + CO2. Mean inspiratory velocity also decreased from 13 ± 2 to 8 ± 1 cm/s during these conditions. All variables returned to baseline during recovery + CO2. Ultrasonography can be used to quantify diaphragm function and identify piglet diaphragm fatigue.
Thèses sur le sujet "Diaphragm ultrasonography"
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Grams, Samantha Torres. « Avaliação da da reprodutibilidade da mobilidade diafragmática pelo método ultrassonográfico indireto ». Universidade do Estado de Santa Catarina, 2011. http://tede.udesc.br/handle/handle/506.
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Objetive: Assessing the reproducibility of the ultrasonographic measurement of craniocaudal displacement of the left branches of the portal vein as a method to evaluate the right hemidiaphragm mobility in healthy young adults. Methods: Forty-one healthy subjects were selected, with age range between 20 and 30 years. The participants of the study were underwent physical examination to measure the cardiorespiratory parameters and anthropometric variables, pulmonary function test, respiratory muscle strength assessment and ultrasonographic evaluation of the the right hemidiaphragm mobility. The implementation and interpretation of ultrasound imaging were performed by two observers (A and B), independently, at two different times (1st and 2nd test). The intra-observer and inter-observer reproducibility and the repeatability of ultrasound measurements were determined by intraclass correlation coefficient (ICC[2,1]) with 95% confidence interval (CI). The Bland & Altman plot was also used, because it allows better visualization of agreement between measures. The level of significance for statistical treatment was 5% (p0,05). Results: From the forty-one subjects participated in study, 27 were females (66%) and 14 males (34%), with means age of 24,8 ± 2,7 years. In the analysis of inter-observer reproducibility, the ICC[2,1] indicated "high correlation" for both the 1st and the 2nd test (ICC[2,1] = 0.83, 95% CI = 0.70 to 0.91 and ICC[2,1] = 0.79, 95% CI = 0.61 to 0.89, respectively). In the analysis of intra-observer reproducibility, the ICC[2,1] indicated "moderate correlation" for observer A (ICC[2,1] = 0,69, 95% CI = 0.45 to 0.84) and for observer B (ICC[2,1] = 0.65, 95% CI = 0.39 to 0.81). In analyzing the repeatability of ultrasound measurements, the ICC[2,1] indicated a "high correlation" for all tests performed (ICC[2,1] = 0.86, 0.80, 0.71, 0.79, p<0.001). Conclusion: The ultrasonographic measurement of craniocaudal displacement of the left branches of the portal vein is a reproducible method for indirect assessment of the right hemidiaphragm mobility in healthy young adults.
Objetivo: Analisar a reprodutibilidade da medida ultrassonográfica do deslocamento crânio-caudal do ramo esquerdo da veia porta como método de avaliação da mobilidade do hemidiafragma direito de adultos jovens saudáveis. Métodos: Foram avaliados 41 indivíduos saudáveis, com idade entre 20 e 30 anos. Os participantes do estudo foram submetidos a exame físico para mensuração dos parâmetros cardiorrespiratórios e das variáveis antropométricas, prova de função pulmonar, avaliação da força muscular respiratória e avaliação ultrassonográfica da mobilidade do hemidiafragma direito. A execução e interpretação dos exames de ultrassom foram realizadas por dois observadores (A e B), de forma independente, em dois momentos distintos (1º e 2º exame). A reprodutibilidade intra e interobservadores e a repetibilidade das medidas ultrassonográficas foram determinadas pelo coeficiente de correlação intraclasse (ICC[2,1]) e pelo intervalo de confiança (IC) de 95%. A disposição gráfica de Bland & Altman também foi utilizada por permitir melhor visualização da concordância entre as medidas. O nível de significância adotado para o tratamento estatístico foi de 5% (p0,05). Resultados: Dos 41 sujeitos, 27 pertenciam ao sexo feminino (66%) e 14 ao sexo masculino (34%); com média de idade de 24,8 ± 2,7 anos. Na análise da reprodutibilidade interobservadores, o ICC[2,1] indicou alta correlação tanto para o 1º quanto para o 2º exame ultrassonográfico (ICC[2,1] = 0,83, IC 95% de 0,70 a 0,91 e ICC[2,1] = 0,79, IC 95% de 0,61 a 0,89, respectivamente). Na análise da reprodutibilidade intra-observador, o ICC[2,1] indicou moderada correlação para o observador A (ICC[2,1] = 0,69, IC 95% de 0,45 a 0,84) e para o observador B (ICC[2,1] = 0,65, IC 95% de 0,39 a 0,81). Na análise da repetibilidade das medidas ultrassonográficas, o coeficiente de correlação intraclasse indicou alta correlação para todos os exames realizados (ICC[2,1] = 0,86; 0,80; 0,71; 0,79, p<0,001). Conclusão: A medida ultrassonográfica do deslocamento crânio-caudal do ramo esquerdo da veia porta demonstrou ser um método reprodutível para avaliação indireta da mobilidade do hemidiafragma direito de adultos jovens saudáveis.
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Andrade, Juliana Dantas. « Uso da ultrassonografia do diafragma na avaliação da hiperinsuflação dinâmica no portador da doença pulmonar obstrutiva crônica ». Universidade Federal de Sergipe, 2016. https://ri.ufs.br/handle/riufs/3811.
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Introduction: Expiratory air flow limitation, as seen in individuals with chronic obstructive pulmonary disease (COPD), causes pulmonary hyperinflation and dyspnea. Six-minute walking test (6MWT) can be used to stimulate dynamic hyperinflation in COPD patients. Diaphragm mobility evaluation through M mode ultrasonography can be used to evaluate diaphragm dysfunction. The higher the diaphragmatic mobility, the bigger is the variation of muscle shortening resulting from its contraction. Objective: Measure, analyze and relate diaphragmatic mobility and ventilation parameters before and after 6MWT; to classify severity of COPD and to determine physical performance of patients. Materials and methods: Study design was transversal, analytical. The sample was divided in two groups: COPD and control (respiratory healthy individuals), recruited from Hospital Universitário de Sergipe and gyms in the city, evaluated between February 2015 and March 2016. Both groups were submitted to diaphragmatic mobility ultrasonographic evaluation and spirometry without bronchodilator agents before and after 6MWT, anthropometric measuring and answered COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) dyspnea scale and had data about their disease collected. Results: After inclusion and exclusion criteria application, 70 patients remained in COPD group and 65 in Control group. There was significative reduction on diaphragmatic mobility between COPD and Control groups before (1,11±0,35cm; 1,32±0,38cm, respectively) and after (1,00±0,34cm; 1,37±0,35cm, respectively) 6MWT. Walked distance was also different between groups (395,93±70,54m and 450,63±55,08m, respectively, p<0,001). COPD group showed statistic difference before and after 6MWT in gender (p<0,001), smoking (p<0,001), biomass burning exposure (p<0,001), exacerbations (p<0,001), hospitalizations (p<0,001) and GOLD D severity (p=0,016). Conclusion: Significant difference in reduced diaphragmatic mobility in COPD and increased in healthy individuals and lower FVC in COPD without alterations in controls after exercise are suggestive of dynamic hyperinflation development. COPD patients distributed by GOLD severity classification were more frequently from Groups B and D. Mean walking distance was close to values considered of increased risk to mortality and hospitalization and are an alarm about the need to implement preventive measures (pharmacologic and non-pharmacologic) to improve this outcome.Introdução: A limitação do fluxo aéreo expiratório, característico em portadores de doença pulmonar obstrutiva crônica (DPOC), leva à hiperinsuflação pulmonar determinante da sensação de dispneia. O teste de caminhada de seis minutos (TC6’) pode ser utilizado para estimular a hiperinsuflação dinâmica (HD) em pacientes com DPOC. A avaliação da mobilidade do diafragma, através da ultrassonografia modo M, é uma alternativa a ser utilizada para avaliar a disfunção diafragmática. Quanto maior a mobilidade diafragmática maior a variação do encurtamento muscular resultante da sua contração. Objetivos: Mensurar, analisar e relacionar a mobilidade diafragmática e os parâmetros ventilatórios pré e pós teste de caminhada de seis minutos (TC6’); classificar a gravidade da DPOC e determinar o desempenho físico do paciente. Materiais e Métodos: O desenho do estudo foi transversal, analítico. Amostra composta de dois grupos: DPOC e Controle (não portadores de doença pulmonar). O período do estudo foi de fevereiro de 2015 a março de 2016, no Hospital Universitário de Sergipe e academias populares da cidade. Os indivíduos de ambos os grupos fizeram a avaliação ultrassonográfica da mobilidade diafragmática e espirometria sem broncodilatador, antes e após o TC6’, foram submetidos a medidas antropométricas, e colhidos informações sobre a doença, aplicado instrumento de avaliação COPD Assessment Test – CAT e escala de dispneia modified Medical Research Council – mMRC. Resultados: Permaneceram no estudo 70 indivíduos no grupo DPOC e 65 no grupo Controle. Houve diferença significativa na mobilidade diafragmática, entre o grupo DPOC e Controle, antes (1,11±0,35cm; 1,32±0,38cm, respectivamente) e após (1,00±0,34cm; 1,37±0,35cm, respectivamente) do TC6’ (p<0,001). A distância percorrida foi também diferente entre os grupos (395,93±70,54m e 450,63±55,08m, respectivamente, p<0,001). Quando se analisou a mobilidade diafragmática, no grupo DPOC, para sexo (p<0,001), tabagista (p<0,001), exposição a biomassa (p<0,001), exacerbação (p<0,001), hospitalização (p<0,001) e GOLD D (p=0,016) foi significativamente menor, antes e depois do TC6’. Conclusão: Diferença significativa de mobilidade diafragmática reduzida na DPOC e aumentada nos saudáveis respiratórios além de média de CVF menor nesses e inalterada nos controles, após a carga de exercício, são inferência do desenvolvimento de hiperinflação dinâmica. Os portadores da DPOC distribuídos pela classificação GOLD apresentaram maior frequência nos Grupos B e D. A média de distância percorrida foi próximo aos valores considerados para risco de mortalidade e hospitalização, alertando-nos sobre a necessidade de medidas preventivas (farmacológicas e não-farmacológicas) que objetivem a melhoria deste desempenho.
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Trevisan, Maria Elaine. « RESPIRAÇÃO ORAL E FUNÇÃO MUSCULAR RESPIRATÓRIA ». Universidade Federal de Santa Maria, 2014. http://repositorio.ufsm.br/handle/1/3438.
Texte intégralRésumé :
This research aimed at assessing respiratory muscle function, electrical activity of the accessory inspiratory muscles, diaphragmatic range of movement (DROM), the palate dimensions and nasal patency in adults with mouth breathing mode (MB), comparing with adults with nasal breathing mode (NB). In the study, 77 adults were selected, from 18 to 30 years old, of both sexes, according the inclusion criteria, allocated in MB (n=38) and NB (n=39) groups. The breathing mode (MB/NB) was diagnosed, based on physical characteristics, the signs and symptoms and on the otorhinolaryngologic examination. It was evaluated anthropometric measurements, maximal inspiratory and expiratory pressures (MIP, MEP), peak nasal inspiratory flow (PNIF), spirometry, nasal obstruction symptoms (NOSE scale), vertical and transverse palate dimensions , ultrasonography of the diaphragm muscle during breathing at Tidal Volume (TV), inspiration at Lung Total Capaciy (LTC) and sniff test. Yet, it was carried out the surface electromyographic (sEMG) of the sternocleidomastoid (SCM) and upper trapezius (UT) for evaluation of the amplitude and symmetry activity (POC%) during rest, inspiration at LTC and in the sniff, MIP and MEP tests. For statistical analysis, SPSS statistical software (version 17.0) was utilized, adopting a significance level of 5 % and the tests Shapiro-Wilk (data normality), Student t and Mann-Whitney (comparison between groups), Intraclass Correlation Coefficient (inter and intra-examiner reproducibility), Pearson and Spearman (correlation between variables) and the chi-square test for nominal variables. In the comparison between groups, the MB had significantly higher mean values for NOSE scale and lower mean values for MIP, MEP, PNIF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and sEMG activity of SCM in the sniff, PNIF and MIP tests. There was no difference in sEMG activity during rest, inspiration TLC, as well as for the POC%. The DROM was lower in the MB group in all tests, with significant difference at rest and TLC. Palate dimensions, in the MB group, showed significantly smaller transverse distance in intercanine region and, bigger in the vertical distance at the premolars and molars regions. The PNIF correlated inversely with the NOSE scale, with the UT sEMG at rest and LTC and, positively, with the FVC, the palate transversal distance, MIP and DROM. The MIP was positively correlated with MEP and FVC. The MB group presented smaller nasal patency, smaller width and higher height of hard palate than NB. The mouth breathing reflected in the smaller values of respiratory pressures, accessory inspiratory muscle electrical activity and diaphragmatic amplitude. As smaller the nasal patency, smaller the respiratory muscle pressure, the diaphragm amplitude and the width of hard palate.Esta pesquisa teve por objetivo verificar a função muscular respiratória, atividade elétrica dos músculos inspiratórios acessórios, amplitude do movimento diafragmático (AMD), dimensões do palato e patência nasal em adultos com modo respiratório oral (RO), comparando-os com adultos com modo respiratório nasal (RN). Foram selecionados 77 adultos, entre 18 e 30 anos de idade, de ambos os sexos, de acordo com os critérios de inclusão, sendo alocados nos grupos RO (n=38) e RN (n=39). O modo respiratório foi diagnosticado baseado nas características físicas, sinais e sintomas e no exame otorrinolaringológico. Avaliou-se medidas antropométricas, pressões inspiratórias e expiratórias máximas (PImáx, PEmáx), pico de fluxo inspiratório nasal (PFIN), espirometria, sintomatologia de obstrução nasal (escala NOSE), dimensões vertical e transversal do palato e ultrassonografia do diafragma durante respiração em volume corrente (VC), inspiração na capacidade pulmonar total (CPT) e teste de sniff. Ainda, realizou-se eletromiografia de superfície (sEMG) dos músculos esternocleidomastoideo (ECM) e trapézio superior (TS), para avaliação da amplitude e índice de simetria da atividade elétrica (POC%) no repouso, inspiração na CPT, sniff, PImáx e PFIN. Para a análise estatística utilizou-se o programa estatístico SPSS (versão 17.0), com nível de significância de 5% e os testes Shapiro-Wilk (normalidade dos dados), t-student e Mann-Whitney (comparação entre os grupos), Coeficiente de Correlação Intraclasse (reprodutibilidade inter e intra-examinadores), Pearson e Spearman (correlação entre as variáveis) e o qui-quadrado (variáveis nominais). Na comparação entre os grupos, os RO apresentaram valores significativamente maiores para a escala NOSE e menores para PImáx, PEmáx, PFIN, capacidade vital forçada (CVF), volume expiratório forçado no primeiro segundo (VEF1) e amplitude da sEMG dos músculos ECM nos testes de sniff, PFIN e PImáx. Não houve diferença na sEMG no repouso e na inspiração em CPT, assim como no POC%. A AMD foi menor no grupo RO em todas as situações testadas, com diferença significante durante o repouso e CPT. O grupo RO apresentou distância transversal do palato significativamente menor na região intercanina e maior na distância vertical, na região dos pré-molares e molares. A medida do PFIN se correlacionou inversamente com a escala NOSE e com a sEMG do TS durante o repouso e CPT. Correlações positivas foram encontradas na medida do PFIN com CVF, distância transversal do palato, PImáx e AMD. A PImáx se correlacionou positivamente com a PEmáx e CVF. O grupo RO apresentou menor patência nasal, menor largura e maior altura do palato duro que o RN. A respiração oral repercutiu em menores valores de pressões respiratórias, de atividade elétrica dos músculos inspiratórios acessórios e de amplitude diafragmática. Quanto menor a patência nasal, menores os valores das pressões respiratórias, a amplitude de movimento do diafragma e a largura do palato duro.
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CAPPELLINI, IACOPO. « Diaphragmatic function in Anesthesia and Intensive Care Unit : Role of ultrasonography in assessing postoperative residual curarization ». Doctoral thesis, 2018. http://hdl.handle.net/2158/1110353.
Texte intégralRésumé :
The extensive use of neuromuscular blocking agents (NMBAs) during surgical procedures has increased the concern of residual paralyzing effect in the post-operative period. In order to avoid residual effects neuromuscular monitoring is advocated in intra-operative setting to improve patient safety. For many years Acetyl Cholinesterase inhibitors (AChEi), has been used to reverse muscle block but their short half-life can cause a partial recurarization in ward setting especially if intermediate-long acting agents are administered. Sugammadex is the first selective reversal drug for steroidal neuromuscular blocking agents, and it has been proved to give full and rapid recovery of muscle strength, thus minimizing the occurrence of residual curarization. Acceleromyography of the adductor of pollicis is the gold standard to detect residual curarization but is not affordable in awake patients. Diaphragm is the major respiratory muscle and its dysfunction is associated with the occurrence of respiratory failure. Introduction of ultrasonography made studying the diaphragm thickness more reliable and a good tool individuate residual effect of NMBAs in awake patients.
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Cavayas, Yiorgos Alexandros. « L’association entre la fonction diaphragmatique préopératoire et le développement de complications respiratoires de la chirurgie cardiaque ». Thèse, 2018. http://hdl.handle.net/1866/21366.
Texte intégralChapitres de livres sur le sujet "Diaphragm ultrasonography"
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Morresey, Peter R. « Ultrasonography of the Pleural Cavity, Lung, and Diaphragm ». Dans Atlas of Equine Ultrasonography, 365–78. Oxford, UK : John Wiley & Sons, Ltd, 2014. http://dx.doi.org/10.1002/9781118798119.ch21.
Texte intégralActes de conférences sur le sujet "Diaphragm ultrasonography"
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Rajbhandari, G. L., F. Davalos, J. Anucha et G. R. Pesola. « Unilateral Diaphragm Paralysis Diagnosed with Ultrasonography ». Dans American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3205.
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Park, Yeonhee, Jung-eun Lee, Jae-hee Seo, Sungju Jee, Kwang Sun Suh, Chang-gyu Lim, Cuk-seong Kim et al. « Diaphragm motion of healthy adults studied by ultrasonography M-mode ». Dans ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.pa2210.
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Hadda, V., R. Kumar, K. Madan, P. Tiwari, S. Mittal, A. Mohan, G. C. Khilnani et R. Guleria. « Trends of Change in Diaphragm Thickness on Bedside Ultrasonography Among Critically Ill Patients ». Dans American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a5658.
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Okura, Kazuki, Masahiro Iwakura, Atsuyoshi Kawagoshi, Keiyu Sugawara, Hitomi Takahashi, Takeshi Kashiwagura, Mitsunobu Homma, Masahiro Satake et Takanobu Shioya. « Contractile capability of diaphragm assessed by ultrasonography correlate with nocturnal oxygen saturation in COPD ». Dans ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.oa3005.
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Ahmad, R., et A. Chichra. « The Use of Diaphragm Ultrasonography to Predict Outcomes in Patients With Acute COPD Exacerbation ». Dans American Thoracic Society 2022 International Conference, May 13-18, 2022 - San Francisco, CA. American Thoracic Society, 2022. http://dx.doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1081.
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Smargiassi, Andrea, Gioacchino Schifino, Bruno Iovene, Linda Tagliaboschi, Giuseppe Maria Corbo, Riccardo Inchingolo et Luca Richeldi. « Ultrasonographic assessment of diaphragm dysfunction in acute exacerbations of COPD ». Dans ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.pa786.
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Bräunlich, Jens, Andreas Hoheisel, Alexandra Wald et Hubert Wirtz. « Ultrasonographic evaluation of the diaphragm during NHF versus NIV use in respiratory failure ». Dans ERS International Congress 2021 abstracts. European Respiratory Society, 2021. http://dx.doi.org/10.1183/13993003.congress-2021.oa1624.
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Abril, Juan C., et Rahul Khosla. « Ultrasonographic Assessment Of The Diaphragm As An Adjunct To The BLUE Protocol In The Diagnosis Of Acute Respiratory Failure ». Dans American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a3071.
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