Articles de revues : « 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, n^o 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, n^o 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, n^o 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, n^o 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, n^o 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, n^o 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, n^o 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, n^o 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, n^o 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, n^o 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.

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Boussuges, Alain, Julie Finance, Guillaume Chaumet et Fabienne Brégeon. « Diaphragmatic motion recorded by M-mode ultrasonography : limits of normality ». ERJ Open Research 7, n^o 1 (janvier 2021) : 00714–2020. http://dx.doi.org/10.1183/23120541.00714-2020.

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Chest ultrasonography has proven to be useful in the diagnosis of diaphragm dysfunction. The aim of the present study was to determine the normal values of the motion of both hemidiaphragms recorded by M-mode ultrasonography.Healthy volunteers were studied while in a seated position. Diaphragmatic excursions and diaphragm profiles were measured during quiet breathing, voluntary sniffing and deep breathing. Diaphragmatic excursions were assessed by M-mode ultrasonography, using an approach perpendicular to the posterior part of the diaphragm. Anatomical M-mode was used for the recording of the complete excursion during deep breathing.The study included 270 men and 140 women. The diaphragmatic motions during quiet breathing and voluntary sniffing were successfully recorded in all of the participants. The use of anatomical M-mode was particularly suitable for measurement of the entire diaphragmatic excursion during deep breathing. The statistical analysis showed that the diaphragmatic excursions were larger in men compared to women, supporting the determination of normal values based on sex. The lower and upper limits of normal excursion were determined for men and women for both hemidiaphragms during the three manoeuvres that were investigated. The lower limits of normal diaphragmatic excursions during deep breathing should be used to detect diaphragmatic hypokinesia, i.e. 3.3 and 3.2 cm in women and 4.1 and 4.2 cm in men for the right and the left sides, respectively.The normal values of the diaphragmatic motion and the lower and upper limits of normal excursion can be used by clinicians to detect diaphragmatic dysfunction.

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Alam, Mohammad Jhahidul, Simanta Roy, Mohammad Azmain Iktidar, Fahmida Khatun Padma, Khairul Islam Nipun, Sreshtha Chowdhury, Ranjan Kumar Nath et Harun-Or Rashid. « Diaphragm ultrasound as a better predictor of successful extubation from mechanical ventilation than rapid shallow breathing index ». Acute and Critical Care 37, n^o 1 (28 février 2022) : 94–100. http://dx.doi.org/10.4266/acc.2021.01354.

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Background: In 3%–19% of patients, reintubation is needed 48–72 hours following extubation, which increases intensive care unit (ICU) morbidity, mortality, and expenses. Extubation failure is frequently caused by diaphragm dysfunction. Ultrasonography can be used to determine the mobility and thickness of the diaphragm. This study looked at the role of diaphragm excursion (DE) and thickening fraction in predicting successful extubation from mechanical ventilation.Methods: Thirty-one patients were extubated with the advice of an ICU consultant using the ICU weaning regimen and diaphragm ultrasonography was performed. Ultrasound DE and thickening fraction were measured three times: at the commencement of the t-piece experiment, at 10 minutes, and immediately before extubation. All patients' parameters were monitored for 48 hours after extubation. Rapid shallow breathing index (RSBI) was also measured at the same time.Results: Successful extubation was significantly correlated with DE (P=0.01). Receiver curve analysis for DE to predict successful extubation revealed good properties (area under the curve [AUC], 0.83; P<0.001); sensitivity, 77.8%; specificity, 84.6%, positive predictive value (PPV), 87.5%; negative predictive value (NPV), 73.3% while cut-off value, 11.43 mm. Diaphragm thickening fraction (DTF) also revealed moderate curve properties (AUC, 0.69; P=0.06); sensitivity, 61.1%; specificity, 84.6%; PPV, 87.5%; NPV, 61.1% with cut-off value 22.33% although former one was slightly better. RSBI could not reach good receiver operating characteristic value at cut-off points 100 b/min/L (AUC, 0.58; P=0.47); sensitivity, 66.7%; specificity, 53.8%; PPV, 66.7%; NPV, 53.8%). Conclusions: To decrease the rate of reintubation, DE and DTF are better indicators of successful extubation. DE outperforms DTF.

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Hadda, Vijay, Pawan Tiwari, Saurabh Mittal, Karan Madan et Anant Mohan. « Ultrasonography of diaphragm in chronic obstructive pulmonary disease : Unanswered questions ». Lung India 37, n^o 1 (2020) : 83. http://dx.doi.org/10.4103/lungindia.lungindia_312_19.

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Nair, Girija, Sanket Jain et Abhishek Nuchin. « Study of diaphragm in chronic obstructive pulmonary disease using ultrasonography ». Lung India 37, n^o 3 (2020) : 288. http://dx.doi.org/10.4103/lungindia.lungindia_467_19.

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Boussuges, Alain, Fabienne Brégeon, Philippe Blanc, Jean-Marie Gil et Laurent Poirette. « Characteristics of the paralysed diaphragm studied by M-mode ultrasonography ». Clinical Physiology and Functional Imaging 39, n^o 2 (16 octobre 2018) : 143–49. http://dx.doi.org/10.1111/cpf.12549.

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Palkar, Atul, Paul Mayo, Karan Singh, Seth Koenig, Mangala Narasimhan, Anup Singh, Rivkah Darabaner, Harly Greenberg et Eric Gottesman. « Serial Diaphragm Ultrasonography to Predict Successful Discontinuation of Mechanical Ventilation ». Lung 196, n^o 3 (19 mars 2018) : 363–68. http://dx.doi.org/10.1007/s00408-018-0106-x.

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Li, Fengrong, Kaiyan Wang, Kunpeng Liu et Mahsa Ebrahimi. « The Application of Pelvic Floor Ultrasound Image Analysis Technology in the Neurorehabilitation of Postpartum Urinary Incontinence ». Journal of Medical Imaging and Health Informatics 11, n^o 2 (1 février 2021) : 618–22. http://dx.doi.org/10.1166/jmihi.2021.3330.

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Objective: To evaluate the outcome of neurorehabilitation on the structure of the pelvic floor muscle (PFM) of parturient women by using the image analysis technology of PFM ultrasonography, and to explore the imaging indexes for the comprehensive evaluation of the therapeutic outcome of postpartum urinary incontinence (PUI), thus providing a direct and reliable imaging basis for the clinic. Methods: From January 2017 to July 2019, 80 patients suffering from stress incontinence were included. All patients were divided into the control group (40 patients) and the rehabilitation group (40 patients) randomly. They received routine guidance, health education, and neurorehabilitation, respectively. The PFM was examined and the therapeutic outcome was evaluated by the PFM ultrasonography image analysis technology. Results: Compared to the control group, in the resting state, the levels of pelvic diaphragm hiatus diameter (PHD), pelvic diaphragm hiatus transverse diameter (PHTD), pelvic diaphragm hiatus area (PHA), and the horizontal angle of levator ani muscle (LAM) hiatus of the rehabilitation group were notably lower; in the maximum Valsalva action, the PHD, PHTD, and PHA levels of the rehabilitation group were notably lower; in the anorectal movement, the PHD, PHTD, and PHA levels of the rehabilitation group were notably decreased, and the total effectiveness of the rehabilitation group was notably higher. Conclusion: PFM ultrasonography image analysis technology can dynamically observe the changes of PFM structure parameters before and after neurorehabilitation, which is worthy of clinical application. PHD, PHTD and PHA can be used as important imaging indicators to measure the outcome of neurorehabilitation.

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Kocjan, Janusz, Bożena Gzik-Zroska, Katarzyna Nowakowska-Lipiec, Michał Burkacki, Sławomir Suchoń, Robert Michnik, Damian Czyżewski et Mariusz Adamek. « Thoracic surgery may alter body static balance via diaphragm dysfunction ». PLOS ONE 17, n^o 8 (31 août 2022) : e0273641. http://dx.doi.org/10.1371/journal.pone.0273641.

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Many diseases and conditions can alter an ability to maintain body balance. The aim of the present study was to investigate whether thoracic surgery may elicit diaphragm dysfunction thereby impairing postural stability. 40 patients qualified to video-assisted thoracoscopy (VATS) lobectomy or lobectomy via thoracotomy due to pulmonary carcinoma were examined two times: a day before lung resection and 3–5 days after surgical procedure. Diaphragm assessment was performed using ultrasonography, while postural sways were evaluated by Zebris FDM-S stabilometric platform. Thoracic surgery was associated with decrease of diaphragm thickness and movement, as well as, with deterioration of static body balance maintenance. Upper lobe resection was linked with greater diaphragm excursion restriction and worse body sway parameters than middle and lower lobe resection. VATS lobectomy was associated with better postoperative diaphragm function and better postural sway parameters than lobectomy via thoracotomy. Patients after lobectomy via thoracotomy had significantly more load on lower limb on the operated side than patients after VATS lobectomy. Impairment of diaphragm function is closely associated with equilibrium impairment after pulmonary resection. VATS lobectomy was less invasive than lobectomy via thoracotomy in terms of primary respiratory muscle function and body balance maintenance parameters.

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Nilsson, P. E., P. Aspelin, O. Ekberg et J. Senyk. « Radiologic Diagnosis in Traumatic Rupture of the Right Diaphragm ». Acta Radiologica 29, n^o 6 (novembre 1988) : 653–55. http://dx.doi.org/10.1177/028418518802900608.

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A case of right-sided diaphragmatic rupture due to blunt trauma is reported. The diagnosis was confirmed by sonography and diagnostic pneumoperitoneum. Ultrasonography was of great value by showing a discontinuous, ‘flapping’ ruptured diaphragm. Computed tomography was of no value. It was concluded that when right-sided diaphragmatic rupture is suggested sonographic examination should be performed. If the sonographic examination is non-diagnostic, a pneumoperitoneum should follow.

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Xiao, Wenwu, Fuming Zheng, Ke Dong, Zhuangfu Wang, Yao Zu et Chuhuai Wang. « Ultrasonography Comparison of Diaphragm Morphological Structure and Function in Young and Middle-Aged Subjects with and without Non-Specific Chronic Low Back Pain : A Case-Control Study ». Pain Research and Management 2022 (16 décembre 2022) : 1–8. http://dx.doi.org/10.1155/2022/7929982.

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Background. It is reported that impaired postural control in patients with non-specific chronic low back pain (NCLBP) was associated with “core” trunk muscle incoordination. However, as the diaphragm is an important component of the “core” deep trunk muscle group, we still know little about the potential relationship between diaphragm dysfunction and NCLBP. Objectives. This case-control study is intended to investigate the changes of diaphragm morphological structure and function in young and middle-aged subjects with and without NCLBP by ultrasound evaluation and its possible validity in predicating the occurrence of NCLBP. Methods. 31 subjects with NCLBP (NCLBP group) and 32 matched healthy controls (HC group) were enrolled in this study. The diaphragm thickness at the end of inspiration (Tins) or expiration (Texp) during deep breathing was measured through B-mode ultrasound, and the diaphragm excursion (Texc) was estimated at deep breathing through M-mode ultrasound. The diaphragm thickness change rate (Trate) was calculated by the formula: T r a t e = T i n s − T exp / T exp × 100 % . Results. Compared with the HC group, the NCLBP group had a significant smaller degree of Tins (t = −3.90, P < 0.001 ), Texp (Z = −2.79, P = 0.005 ), and Trate (t = −2.03, P = 0.047 ). However, there was no statistical difference in Texc between the two groups (t = −1.42, P = 0.161 ). The binary logistic regression analysis indicated that Trate (OR = 16.038, P = 0.014 ) and Texp (OR = 7.714, P = 0.004 ) were potential risk factors for the occurrence of NCLBP. Conclusions. The diaphragm morphological structure and function were changed in young and middle-aged subjects with NCLBP, while the diaphragm thickness change rate (Trate) and diaphragm thickness at the end of expiration (Texp) may be conductive to the occurrence of NCLBP. Furthermore, these findings may suggest that abnormal diaphragm reeducation is necessary for the rehabilitation of patients with NCLBP.

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Athar, Hakim, Jitender Mohindroo, Kiranjeet Singh, Ashwani Kumar et Mulinti Raghunath. « Comparison of Radiography and Ultrasonography for Diagnosis of Diaphragmatic Hernia in Bovines ». Veterinary Medicine International 2010 (2010) : 1–7. http://dx.doi.org/10.4061/2010/939870.

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The present study was conducted on 101 animals suffering from thoracoabdominal disorders; out of which twenty seven animals (twenty six buffaloes and one cow) were diagnosed with diaphragmatic hernia based on clinical signs, radiography, ultrasonography, and left flank laparorumenotomy. Radiography alone confirmed diaphragmatic hernia in 18 cases (66.67%) with a sac-like structure cranial to the diaphragm. In 15 animals the sac contained metallic densities while in three cases a sac-like structure with no metallic densities was present. Ultrasonography was helpful in confirming diaphragmatic hernia in 23 cases (85.18%) and ultrasonographically reticular motility was evident at the level of 4th/5th intercostal space in all the animals. B+M mode ultrasonography was used for the first time for diagnosis of diaphragmatic hernia in bovines and the results suggested that ultrasonography was a reliable diagnostic modality for diaphragmatic hernia in bovines.

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Nair, Girija, Sanket Jain, Abhishek Nuchin et Abhay Uppe. « Study of the diaphragm in chronic obstructive pulmonary disease using ultrasonography ». Lung India 36, n^o 4 (2019) : 299. http://dx.doi.org/10.4103/lungindia.lungindia_466_18.

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Aliberti, Stefano, Grazia Messinesi, Andrea Gramegna, Lucio Tremolizzo, Emanuela Susani et Alberto Pesci. « Diaphragm ultrasonography in the management of patients with amyotrophic lateral sclerosis ». Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration 14, n^o 2 (15 janvier 2013) : 154–56. http://dx.doi.org/10.3109/21678421.2012.762931.

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Mikura, Sunao, Takeshi Saraya, Taro Minami, Toru Satoh et Hajime Takizawa. « Diaphragm Ultrasonography as an Important Aid to Diagnose Spinal Cord Injury ». Pulmonary Research and Respiratory Medicine - Open Journal SE, n^o 1 (16 mai 2017) : S27—S30. http://dx.doi.org/10.17140/prrmoj-se-1-110.

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Kim, Won Young, Hee Jung Suh, Sang-Bum Hong, Younsuck Koh et Chae-Man Lim. « Diaphragm dysfunction assessed by ultrasonography : Influence on weaning from mechanical ventilation* ». Critical Care Medicine 39, n^o 12 (décembre 2011) : 2627–30. http://dx.doi.org/10.1097/ccm.0b013e3182266408.

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Haloho, Agustina, Rudyanto Sedono, Adhrie Sugiarto et Zulkifli Zulkifli. « Relationship between Neutrophil to Lymphocyte Ratio with Diaphragm Thickness in Critical Patients ». Bioscientia Medicina : Journal of Biomedicine and Translational Research 4, n^o 2 (2 avril 2020) : 1–9. http://dx.doi.org/10.32539/bsm.v4i2.121.

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Abstract Background: The cause of weaning failure is multifactorial. One of the causes was Ventilator Induced Diaphragm Dysfunction (VIDD) due to thinning process of the diaphragm thickness. Decreased diaphragm muscle mass might occur due to inflammatory process. Methods: The study was an observational analytic study from September 2018 to January 2019 in Mohammad Hoesin Hospital, Palembang â€“ Indonesia. Ethical appoval for the study was obtained from Ethics Committee and subjects were recruited after signing the informed consents. Only 30 subjects were involved in the end of the study. About 6 mL of blood sample from cubital vein was withdrawn from each subject to measure neutrophils and lymphocytes. Patientsâ€™ diaphragm thickness was measured by using ultrasonography on 0th, 3rd, 5th day. Collected data were then analyzed with STATA 15. Results: The chi-square test showed that the relationship of NLR (neutophil to lymphocyte ratio) of the 0th day to the decrease in diaphragm thickness on the 3rd day was not significant (p = 0.254), while the decrease in diaphragm thickness on the 5th day was significant (p = 0.015). Subjects with initial NLR values >7 had a significant higher risk of having decreased diaphragm thickness compared to subjects with initial NLR values â€‹â€‹â‰¤7 (RR = 1.62 (0.99-2.64); p-value = 0.003). Conclusion: Neutrophil to lymphocyte ratio affected the decrease of diaphragm thickness in patients using mechanical ventilation.

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Reddy, Ajit, Anil K. Shukla, Sowmya Anand et Nitish Suresh. « Imaging of a Rare Case of Diaphragmatic Tumor ». Journal of Medical Sciences 3, n^o 1 (2017) : 25–27. http://dx.doi.org/10.5005/jp-journals-10045-0050.

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ABSTRACT Primary tumors of the diaphragm are quite rare. About 150 cases have been reported in the literature. Fibrosarcomas are the most common malignant neoplasms of the diaphragm; however, only a few (less than 20) cases have been reported to date. We present a case of an extremely rare tumor of the diaphragm. A 65-year-old woman presented with history of vague upper abdominal pain since 2 months and distension for 2 weeks. Ultrasonography features were in favor of a mass arising from left dome of diaphragm with evidence of vascularity on Doppler; lesion was displacing spleen inferiorly. Contrast-enhanced computed tomography scan of the abdomen revealed a mass located in the region of the left dome of diaphragm and deriving blood supply from the branches of abdominal aorta. Surgical excision was planned, keeping in mind the diagnosis of a left diaphragmatic tumor. Laparotomy revealed a left diaphragmatic tumor growing caudally into the upper abdomen. How to cite this article Anand S, Suresh N, Reddy AK, Shukla AK. Imaging of a Rare Case of Diaphragmatic Tumor. J Med Sci 2017;3(1):25-27.

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Martins, Gloria, Juan Carlos Rosso Verdeal, Helio Tostes, Alice Ramos Oliveira da Silva, Bernardo Tessarollo, Nazareth Novaes Rocha, Patricia Rieken Macedo Rocco et Pedro Leme Silva. « Testosterone Therapy and Diaphragm Performance in a Male Patient with COVID-19 : A Case Report ». Diagnostics 12, n^o 2 (19 février 2022) : 535. http://dx.doi.org/10.3390/diagnostics12020535.

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Low levels of testosterone may lead to reduced diaphragm excursion and inspiratory time during COVID-19 infection. We report the case of a 38-year-old man with a positive result on a reverse transcriptase-polymerase chain reaction test for SARS-CoV-2, admitted to the intensive care unit with acute respiratory failure. After several days on mechanical ventilation and use of rescue therapies, during the weaning phase, the patient presented dyspnea associated with low diaphragm performance (diaphragm thickness fraction, amplitude, and the excursion-time index during inspiration were 37%, 1.7 cm, and 2.6 cm/s, respectively) by ultrasonography and reduced testosterone levels (total testosterone, bioavailable testosterone and sex hormone binding globulin (SHBG) levels were 9.3 ng/dL, 5.8 ng/dL, and 10.5 nmol/L, respectively). Testosterone was administered three times 2 weeks apart (testosterone undecanoate 1000 mg/4 mL intramuscularly). Diaphragm performance improved significantly (diaphragm thickness fraction, amplitude, and the excursion-time index during inspiration were 70%, 2.4 cm, and 3.0 cm/s, respectively) 45 and 75 days after the first dose of testosterone. No adverse events were observed, although monitoring was required after testosterone administration. Testosterone replacement therapy led to good diaphragm performance in a male patient with COVID-19. This should be interpreted with caution due to the exploratory nature of the study.

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Yu, Jihion, Yongsoo Lee, Jun-Young Park, Jai-Hyun Hwang et Young-Kug Kim. « Diaphragm Thickening Fraction as a Prognostic Imaging Marker for Postoperative Pulmonary Complications in Robot-Assisted Laparoscopic Prostatectomy Requiring the Trendelenburg Position and Pneumoperitoneum ». Disease Markers 2021 (22 juin 2021) : 1–9. http://dx.doi.org/10.1155/2021/9931690.

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Background. Robot-assisted laparoscopic prostatectomy (RALP) frequently entails postoperative pulmonary complications (PPCs) due to the Trendelenburg position and pneumoperitoneum. Diaphragm thickening fraction (TF) as an imaging marker can offer the advantage of predicting respiratory outcomes. Therefore, we evaluated the effect of diaphragm TF on the occurrence of PPCs in RALP. Methods. We measured the preoperative thickness of the diaphragm at peak inspiration ( T pi ) and end expiration ( T ee ) using ultrasonography. Diaphragm TF was calculated as TF = T pi – T ee / T ee . A receiver operating characteristic (ROC) curve analysis of TF was performed. After dividing patients into two groups according to the optimal TF cut-off value, we compared the occurrence of PPCs between the groups. The predictivity of diaphragm TF for the occurrence of PPCs was evaluated. Results. Of 145 patients, 40 patients (27.6%) developed PPCs. Patients with PPCs had a significantly lower TF than those without PPCs ( 0.31 ± 0.09 vs. 0.39 ± 0.11 , P < 0.001 ). In the ROC curve analysis, the optimal TF cut-off value was 0.28. The patients were divided into TF ≥ 0.28 group ( n = 114 ) and TF < 0.28 group ( n = 31 ). The incidence of PPCs was significantly higher in the TF < 0.28 group than in the TF ≥ 0.28 group (51.6% vs. 21.1%, P = 0.001 ). Diaphragm TF < 0.28 was associated with a higher incidence of PPCs than diaphragm TF ≥ 0.28 ( odds ratio = 4.534 , 95% confidence interval [1.763–11.658], P = 0.002 ). Conclusion. Preoperative diaphragm TF < 0.28 was associated with an increased incidence of PPCs, suggesting that diaphragm TF as a prognostic imaging marker provides useful information on PPCs in RALP requiring the Trendelenburg position and pneumoperitoneum. Trial Registry Number. This trial is registered with KCT0005028.

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Aliverti, A., G. Ghidoli, R. L. Dellacà, A. Pedotti et P. T. Macklem. « Chest wall kinematic determinants of diaphragm length by optoelectronic plethysmography and ultrasonography ». Journal of Applied Physiology 94, n^o 2 (1 février 2003) : 621–30. http://dx.doi.org/10.1152/japplphysiol.00329.2002.

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To estimate diaphragm fiber length from thoracoabdominal configuration, we measured axial motion of the right-sided area of apposition by ultrasonography and volumes displaced by chest wall compartments [pulmonary, abdominal rib cage, and abdomen (Vab)] by optoelectronic plethysmography in four normal men during quiet breathing and incremental exercise without and with expiratory flow limitation. Points at the cephalic area of apposition border were digitized from echo images and mapped into three-dimensional space, and the axial distance from the xyphoidal transverse plane (Dap) was measured simultaneously with the volumes. Linear regression analysis between changes (Δ) in Dap and the measured volume changes under all conditions showed that 1) ΔDap was linearly related more to ΔVab than to changes in pulmonary and abdominal rib cage volumes; and 2) this was highly repeatable between measures. Multiple stepwise regression analysis showed that ΔVab accounted for 89–96% of the variability of ΔDap, whereas the rib cage compartments added <1%. We conclude that, under conditions of quiet breathing and exercise, with and without expiratory flow limitation, instantaneous ΔDap can be estimated from ΔVab.

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Malas, Fevziye Ünsal, Füsun Köseoğlu, Murat Kara, Hilal Ece, Meltem Aytekin, Gökhan T. Öztürk, Levent Özçakar et Alper M. Ulaşlı. « Diaphragm ultrasonography and pulmonary function tests in patients with spinal cord injury ». Spinal Cord 57, n^o 8 (9 avril 2019) : 679–83. http://dx.doi.org/10.1038/s41393-019-0275-3.

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Dhungana, Ashesh, Gopi Khilnani, Vijay Hadda et Randeep Guleria. « Reproducibility of diaphragm thickness measurements by ultrasonography in patients on mechanical ventilation ». World Journal of Critical Care Medicine 6, n^o 4 (4 novembre 2017) : 185–89. http://dx.doi.org/10.5492/wjccm.v6.i4.185.

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Palkar, Atul, Rivkah Darabaner, Karan Singh, Anup Singh, Meredith Akerman, Paul Mayo et Eric Gottesman. « Serial Lung and Diaphragm Ultrasonography to Predict Successful Discontinuation of Mechanical Ventilation ». Chest 150, n^o 4 (octobre 2016) : 465A. http://dx.doi.org/10.1016/j.chest.2016.08.478.

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Vivier, Emmanuel, Armand Mekontso Dessap, Saoussen Dimassi, Frederic Vargas, Aissam Lyazidi, Arnaud W. Thille et Laurent Brochard. « Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation ». Intensive Care Medicine 38, n^o 5 (5 avril 2012) : 796–803. http://dx.doi.org/10.1007/s00134-012-2547-7.

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Nair, Aishwarya, Gopala Krishna Alaparthi, Shyam Krishnan, Santhosh Rai, R. Anand, Vishak Acharya et Preetam Acharya. « Comparison of Diaphragmatic Stretch Technique and Manual Diaphragm Release Technique on Diaphragmatic Excursion in Chronic Obstructive Pulmonary Disease : A Randomized Crossover Trial ». Pulmonary Medicine 2019 (3 janvier 2019) : 1–7. http://dx.doi.org/10.1155/2019/6364376.

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Background. Chronic Obstructive Pulmonary Disease (COPD) impairs the function of the diaphragm by placing it at a mechanical disadvantage, shortening its operating length and changing the mechanical linkage between its various parts. This makes the diaphragm’s contraction less effective in raising and expanding the lower rib cage, thereby increasing the work of breathing and reducing the functional capacity. Aim of the Study. To compare the effects of diaphragmatic stretch and manual diaphragm release technique on diaphragmatic excursion in patients with COPD. Materials and Methods. This randomised crossover trial included 20 clinically stable patients with mild and moderate COPD classified according to the GOLD criteria. The patients were allocated to group A or group B by block randomization done by primary investigator. The information about the technique was concealed in a sealed opaque envelope and revealed to the patients only after allocation of groups. After taking the demographic data and baseline values of the outcome measures (diaphragm mobility by ultrasonography performed by an experienced radiologist and chest expansion by inch tape performed by the therapist), group A subjects underwent the diaphragmatic stretch technique and the group B subjects underwent the manual diaphragm release technique. Both the interventions were performed in 2 sets of 10 deep breaths with 1-minute interval between the sets. The two outcome variables were recorded immediately after the intervention. A wash-out period of 3 hours was maintained to neutralize the effect of given intervention. Later the patients of group A and group B were crossed over to the other group. Results. In the diaphragmatic stretch technique, there was a statistically significant improvement in the diaphragmatic excursion before and after the treatment. On the right side, p=0.00 and p=0.003 in the midclavicular line and midaxillary line. On the left side, p=0.004 and p=0.312 in the midclavicular and midaxillary line. In manual diaphragm release technique, there was a statistically significant improvement before and after the treatment. On the right side, p=0.000 and p=0.000 in the midclavicular line and midaxillary line. On the left side, p=0.002 and p=0.000 in the midclavicular line and midaxillary line. There was no statistically significant difference in diaphragmatic excursion in the comparison of the postintervention values of both techniques. Conclusion. The diaphragmatic stretch technique and manual diaphragm release technique can be safely recommended for patients with clinically stable COPD to improve diaphragmatic excursion.

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El-Mogy, Mohamed, Hanan El-Halaby, Gehan Attia et Hesham Abdel-Hady. « Comparative Study of the Effects of Continuous Positive Airway Pressure and Nasal High-Flow Therapy on Diaphragmatic Dimensions in Preterm Infants ». American Journal of Perinatology 35, n^o 05 (13 novembre 2017) : 448–54. http://dx.doi.org/10.1055/s-0037-1608682.

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Objective Nasal continuous positive airway pressure (nCPAP) and nasal high-flow therapy (nHFT) are the most common forms of noninvasive respiratory support in preterm infants. We conducted this study to compare effects of nCPAP and nHFT on diaphragmatic dimensions as assessed by bedside ultrasonography in preterm infants. Study Design A prospective, randomized crossover study comprised 24 preterm infants. Group 1 (n = 12): started on nCPAP for 60 minutes and then switched to nHFT for 60 minutes. Group 2 (n = 12): started on nHFT for 60 minutes then switched to nCPAP for 60 minutes. Ultrasonographic assessment of diaphragmatic dimensions was performed at the end of each epoch. Results There were no statistically significant differences in diaphragmatic dimensions at the end of each epoch of nCPAP or nHFT. The diaphragm thickening fraction (DTF) was not significantly different with either nCPAP or nHFT [23.4 (13.7–28.0) versus 23.4 (11.2–31.6), p = 0.57]. No significant differences were found regarding heart rate, respiratory rate, Silverman–Anderson scores, and SpO2 on nCPAP and nHFT. All infants enrolled tolerated the crossover maneuver. Conclusion Stable preterm infants (30.3 ± 2.2 weeks' gestation) with mild respiratory dysfunction show comparable effects on diaphragm thickness and excursion during relatively brief periods of support on nCPAP or nHFT. Clinical Trial Registration Registry name: Clinical Trials.gov. Registration number: NCT02421328. Web link to study on registry: https://clinicaltrials.gov/ct2/show/NCT02421328.

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Marugán-Rubio, Daniel, Jose L. Chicharro, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, David Rodríguez-Sanz, Davinia Vicente-Campos, Gabriel J. Dávila-Sánchez et César Calvo-Lobo. « Concurrent Validity and Reliability of Manual Versus Specific Device Transcostal Measurements for Breathing Diaphragm Thickness by Ultrasonography in Lumbopelvic Pain Athletes ». Sensors 21, n^o 13 (24 juin 2021) : 4329. http://dx.doi.org/10.3390/s21134329.

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The use of rehabilitative ultrasound imaging (RUSI) to evaluate diaphragm thickness during breathing in athletes who suffer from non-specific lumbopelvic pain presents some measurement errors. The purpose of this study was to evaluate intra- and inter-sessions, intra- and inter-rater reliabilities, and concurrent validity of diaphragm thickness measurements during breathing using transcostal RUSI with a novel thoracic orthotic device that was used to fix the US probe versus those measurements obtained using manual fixation. A total of 37 athletes with non-specific lumbopelvic pain were recruited. Intra- (same examiner) and inter-rater (two examiners) and intra- (same day) and inter-session (alternate days) reliabilities were analyzed. All measurements were obtained after manual probe fixation and after positioning the thoracic orthotic device to fix the US probe in order to correctly correlate both measurement methods. Both left and right hemi-diaphragm thickness measurements were performed by transcostal RUSI at maximum inspiration, expiration, and the difference between the two parameters during relaxed breathing. Intra-class correlation coefficients (ICC), standard errors of measurement (SEM), minimum detectable changes (MCD), systematic errors, and correlations (r) were assessed. Orthotic device probe fixation showed excellent reliability (ICC = 0.852–0.996, SEM = 0.0002–0.054, and MDC = 0.002–0.072), and most measurements did not show significant systematic errors (p > 0.05). Despite manual probe fixation with a reliability ranging from good to excellent (ICC = 0.714–0.997, SEM = 0.003–0.023, and MDC = 0.008–0.064 cm), several significant systematic measurement errors (p < 0.05) were found. Most significant correlations between both orthotic device and manual probe fixation methods were moderate (r = 0.486–0.718; p < 0.05). Bland–Altman plots indicated adequate agreement between both measurement methods according to the agreement limits. The proposed novel thoracic orthotic device may allow ultrasound probe fixation to provide valid and reliable transcostal RUSI measurements of diaphragmatic thickness during relaxed breathing thus reducing some measurement errors and avoiding systematic measurement errors. It may be advisable to measure diaphragm thickness and facilitate visual biofeedback with respect to diaphragm re-education during normal breathing in athletes with non-specific lumbopelvic pain.

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Alaparthi, Gopala Krishna, Alfred Joseph Augustine, R. Anand et Ajith Mahale. « Comparison of Diaphragmatic Breathing Exercise, Volume and Flow Incentive Spirometry, on Diaphragm Excursion and Pulmonary Function in Patients Undergoing Laparoscopic Surgery : A Randomized Controlled Trial ». Minimally Invasive Surgery 2016 (2016) : 1–12. http://dx.doi.org/10.1155/2016/1967532.

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Objective.To evaluate the effects of diaphragmatic breathing exercises and flow and volume-oriented incentive spirometry on pulmonary function and diaphragm excursion in patients undergoing laparoscopic abdominal surgery.Methodology.We selected 260 patients posted for laparoscopic abdominal surgery and they were block randomization as follows: 65 patients performed diaphragmatic breathing exercises, 65 patients performed flow incentive spirometry, 65 patients performed volume incentive spirometry, and 65 patients participated as a control group. All of them underwent evaluation of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow Rate (PEFR), and diaphragm excursion measurement by ultrasonography before the operation and on the first and second postoperative days. With the level of significance set atp<0.05.Results.Pulmonary function and diaphragm excursion showed a significant decrease on the first postoperative day in all four groups (p<0.001) but was evident more in the control group than in the experimental groups. On the second postoperative day pulmonary function (Forced Vital Capacity) and diaphragm excursion were found to be better preserved in volume incentive spirometry and diaphragmatic breathing exercise group than in the flow incentive spirometry group and the control group. Pulmonary function (Forced Vital Capacity) and diaphragm excursion showed statistically significant differences between volume incentive spirometry and diaphragmatic breathing exercise group (p<0.05) as compared to that flow incentive spirometry group and the control group.Conclusion. Volume incentive spirometry and diaphragmatic breathing exercise can be recommended as an intervention for all patients pre- and postoperatively, over flow-oriented incentive spirometry for the generation and sustenance of pulmonary function and diaphragm excursion in the management of laparoscopic abdominal surgery.

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Yun, Hye Joo, Dakyung Hong, Sung Jun Kim, Hye Won Chung et Hyun Sik Chung. « Effects of Dexmedetomidine on Diaphragm Activity Measured by Ultrasonography in Spontaneously Breathing Patients ». International Journal of Medical Sciences 19, n^o 11 (2022) : 1631–37. http://dx.doi.org/10.7150/ijms.76495.

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Scott, Samantha, Jonathan P. Fuld, Roger Carter, Margaret McEntegart et Niall G. MacFarlane. « Diaphragm Ultrasonography as an Alternative to Whole-Body Plethysmography in Pulmonary Function Testing ». Journal of Ultrasound in Medicine 25, n^o 2 (février 2006) : 225–32. http://dx.doi.org/10.7863/jum.2006.25.2.225.

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Gómez-Zamora, Ana, Diego Rodriguez-Álvarez, Iria Durán-Lorenzo, Cristina Schüffelmann, Miguel Rodríguez-Rubio et Paloma Dorao Martinez-Romillo. « Diaphragm Ultrasonography to Predict Noninvasive Respiratory Treatment Failure in Infants With Severe Bronchiolitis ». Respiratory Care 67, n^o 4 (15 mars 2022) : 455–63. http://dx.doi.org/10.4187/respcare.09414.

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Whitehead, Nicholas P., Kenneth L. Bible, Min Jeong Kim, Guy L. Odom, Marvin E. Adams et Stanley C. Froehner. « Validation of ultrasonography for non-invasive assessment of diaphragm function in muscular dystrophy ». Journal of Physiology 594, n^o 24 (13 octobre 2016) : 7215–27. http://dx.doi.org/10.1113/jp272707.

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Stukan, Maciej, Antonio Bugalho, Amanika Kumar, Julita Kowalewska, Dariusz Świetlik, Natalia Buda, Małgorzata Pietrzak-Stukan et Mirosław Dudziak. « Lung and Intercostal Upper Abdomen Ultrasonography for Staging Patients with Ovarian Cancer : A Method Description and Feasibility Study ». Diagnostics 10, n^o 2 (5 février 2020) : 85. http://dx.doi.org/10.3390/diagnostics10020085.

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A detailed transabdominal and transvaginal ultrasound examination, performed by an expert examiner, could render a similar diagnostic performance to computed tomography for assessing pelvic/abdominal tumor spread disease in women with epithelial ovarian cancer (EOC). This study aimed to describe and assess the feasibility of lung and intercostal upper abdomen ultrasonography as pretreatment imaging of EOC metastases of supradiaphragmatic and subdiaphragmatic areas. A preoperative ultrasound examination of consecutive patients suspected of having EOC was prospectively performed using transvaginal, transabdominal, and intercostal lung and upper abdomen ultrasonography. A surgical-pathological examination was the reference standard to ultrasonography. Among 77 patients with histologically proven EOC, supradiaphragmatic disease was detected in 13 cases: pleural effusions on the right (n = 12) and left (n = 8) sides, nodular lesions on diaphragmatic pleura (n = 9), focal lesion in lung parenchyma (n = 1), and enlarged cardiophrenic lymph nodes (n = 1). Performance (described with area under the curve) of combined transabdominal and intercostal upper abdomen ultrasonography for subdiaphragmatic areas (n = 77) included the right and left diaphragm peritoneum (0.754 and 0.575 respectively), spleen hilum (0.924), hepatic hilum (0.701), and liver and spleen parenchyma (0.993 and 1.0 respectively). It was not possible to evaluate the performance of lung ultrasonography for supradiaphragmatic disease because only some patients had this region surgically explored. Preoperative lung and intercostal upper abdomen ultrasonography performed in patients with EOC can add valuable information for supradiaphragmatic and subdiaphragmatic regions. A reliable reference standard to test method performance is an area of future research. A multidisciplinary approach to ovarian cancer utilizing lung ultrasonography may assist in clinical decision-making.

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Pilli, Mehmet, Fatma E. Özgencil, Deniz Seyrek-Intas, Cagri Gültekin et Kürsad Turgut. « Pleuroperitoneal true diaphragmatic hernia of the liver in a cat ». Tierärztliche Praxis Ausgabe K : Kleintiere / Heimtiere 48, n^o 04 (août 2020) : 292–96. http://dx.doi.org/10.1055/a-1200-4080.

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AbstractA 2-year old female domestic shorthair cat was referred with intermittent vomiting. Laboratory analyses revealed only an elevated alanine aminotransferase activity. Plain thoracic radiographs showed a right-sided transdiaphragm protrusion of a liver lobe into the thoracic cavity. On abdominal ultrasound the diaphragm and liver parenchyma also presented a bulge towards the thoracic cavity. By cranial median laparotomy herniation of the quadrate liver lobe through the right aspect of the diaphragm into the thoracic cavity was confirmed. The protruding quadrate liver lobe was covered by intact parietal peritoneum. Following relocation of the liver lobe the defect was closed. Postoperatively the intermittent vomiting stopped. The purpose of this case report was to present plain radiography and abdominal ultrasonography as effective tools in the diagnosis of this rare and usually asymptomatic true herniation case along with its operative treatment.

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Wait, J. L., P. A. Nahormek, W. T. Yost et D. P. Rochester. « Diaphragmatic thickness-lung volume relationship in vivo ». Journal of Applied Physiology 67, n^o 4 (1 octobre 1989) : 1560–68. http://dx.doi.org/10.1152/jappl.1989.67.4.1560.

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To characterize the relationship of changes in diaphragmatic thickness during contraction to changes in lung volume, we developed a technique to measure diaphragm thickness based on M-mode ultrasonography. First, diaphragmatic thickness was measured in situ at necropsy with ultrasound and verified by measuring the same resected segment of diaphragm by ruler (correlation coefficient = 0.93, slope = 0.97). The technique of imaging the diaphragm in living subjects was developed by using a 15-MHz transducer coupled to an M-mode echocardiograph. Ten normal male volunteers were studied while sitting. The ultrasound transducer was held between the ribs in the ninth lateral interspace, and tidal volume was measured by spirometry. The thickening fraction (TF) was calculated as TF = (thickness at peak inspiration - thickness at end expiration)/thickness at end expiration for each of a series of different sized breaths. The function, TF vs. lung volume, for a range of volumes was linear for each subject and had intrasubject reproducibility with intersubject variability. We conclude that diaphragmatic TF is related to function as determined by lung volume, and this may prove to be a useful technique for in vivo studies of diaphragmatic function.

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Hafez, Manal R., Eman SM Sobh, Sawsan B. Elsawy et Omaima I. Abo-Elkheir. « The usefulness of thoracic ultrasonography in diagnosis and staging of bronchogenic carcinoma ». Ultrasound 25, n^o 4 (3 août 2017) : 200–212. http://dx.doi.org/10.1177/1742271x17721264.

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Aim To evaluate (1) the usefulness of thoracic ultrasound in diagnosis and staging of bronchogenic carcinoma by comparing lesion detectability between thoracic- ultrasound and computed tomography and (2) the outcome of thoracic-ultrasound-guided biopsy in diagnosing bronchogenic carcinoma. Methods We conducted a cross-sectional study on 53 patients of confirmed bronchogenic carcinoma. All patients had been investigated by thoracic-ultrasound and chest-computed tomography; data regarding the presence of mass (its size, necrosis), lymph nodes invasion, peritumoural atelectasis, consolidations, pleural effusion, chest wall invasion, and paralysis of the diaphragm were recorded. Thoracic-ultrasound-guided biopsy was done for 41 patients. Results Thoracic-ultrasound had significantly higher detection rate of peritumoural atelectasis, paralysis of the diaphragm, and supraclavicular lymph nodes invasion, while it has significantly lower detection rate of pulmonary masses and mediastinal lymph nodes invasion than computed tomography. It has nonsignificant higher detection rate of pleural effusion, consolidations, chest wall invasion and necrosis within mass than computed tomography. Thoracic-ultrasound detects static air-bronchogram and/or fluid bronchogram in 53.3% of bronchogenic carcinoma-associated consolidation. Thoracic-ultrasound-guided biopsy revealed positive yield in 78.0% (32/41) of patients. All patients with negative thoracic-ultrasound biopsy had mass size >5 cm with necrosis within the mass. Self-limited complications occurred in 26.8% after thoracic-ultrasound-guided biopsy (haemoptysis 22.0%, pneumothorax 2.4% and subcutaneous emphysema 2.4%). Conclusion Thoracic-ultrasound has a significant complementary role to computed tomography in diagnosis and staging of bronchogenic carcinoma. Thoracic-ultrasound-guided biopsy revealed good positive yield (78%), its yield was negatively affected by mass size and necrosis. It is a simple, practical and accurate procedure without significant patients’ risks.

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Gomez-Zamora, A., D. Rodriguez-Álvarez, I. Durán, C. Schuffelmann, C. Román et P. Dorao. « P0434 / #2031 : DIAPHRAGM ULTRASONOGRAPHY TO PREDICT RESPIRATORY FAILURE IN INFANTS WITH MODERATE-SEVERE BRONCHIOLITIS ». Pediatric Critical Care Medicine 22, Supplement 1 3S (mars 2021) : 223. http://dx.doi.org/10.1097/01.pcc.0000740076.61217.c5.

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Fayssoil, Abdallah, Tanya Stojkovic, Adam Ogna, Pascal Laforet, Helene Prigent, Frederic Lofaso, David Orlikowski, Guillaume Bassez, Bruno Eymard et Anthony Behin. « Assessment of diaphragm motion using ultrasonography in a patient with facio-scapulo-humeral dystrophy ». Medicine 98, n^o 4 (janvier 2019) : e13887. http://dx.doi.org/10.1097/md.0000000000013887.

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Okura, Kazuki, Atsuyoshi Kawagoshi, Masahiro Iwakura, Keiyu Sugawara, Hitomi Takahashi, Takeshi Kashiwagura, Mitsunobu Homma, Masahiro Satake et Takanobu Shioya. « Contractile capability of the diaphragm assessed by ultrasonography predicts nocturnal oxygen saturation in COPD ». Respirology 22, n^o 2 (9 septembre 2016) : 301–6. http://dx.doi.org/10.1111/resp.12897.

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Calvo-Lobo, César, Jaime Almazán-Polo, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Patricia Palomo-López, David Rodríguez-Sanz et Daniel López-López. « Ultrasonography comparison of diaphragm thickness and excursion between athletes with and without lumbopelvic pain ». Physical Therapy in Sport 37 (mai 2019) : 128–37. http://dx.doi.org/10.1016/j.ptsp.2019.03.015.

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