Ultrasonographic comparison of the diaphragm function in critically ill patients with volume and pressure modes
Mechanical ventilation and the effect of respiratory muscle unloading on the diaphragm causes atrophy of the diaphragmatic muscle. Aim of the present study was to evaluate the ultra sonographic indices of diaphragm contractile activity (respiratory excursion and thickening) during mechanical ventila...
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| description | Mechanical ventilation and the effect of respiratory muscle unloading on the diaphragm causes atrophy of the diaphragmatic muscle.
Aim of the present study was to evaluate the ultra sonographic indices of diaphragm contractile activity (respiratory excursion and thickening) during mechanical ventilation with Bilevel Positive Airway Pressure (BiPAP) and Synchronized intermittent mandatory ventilation (SIMV), widely used modes in critically ill patients [1].
Eligible patients admitted to the ICU who met criteria equally divided in 2 groups; 1) BiPAP (n = 20) and 2) SIMV (n = 20). Cases of thoracic/gastric/ esophageal surgery, patients with the history of neuromuscular disorders, and who weaned from mechanical ventilation during the first 48 h after ultra sonographic recording were excluded. The right hemidiaphragm was evaluated by B- and M-mode ultrasonography to record diaphragmatic excursion (DE) and thickening fraction (DTF) [2].
In the BiPAP group, DTF values in the first, third and seventh days were 39 ± 9%, 27.8 ± 7.4% and 22 ± 6.5% and diaphragmatic excursion (DE) were 2 ± 0.31 cm, 1.35 ± 0.19 cm and 1.13 ± 0.14 cm respectively. First, third and seventh days DTF values in the SIMV group, were 32 ± 5.1%, 25 ± 4.2% and 21.5 ± 4.47%; and DE were 1.9 ± 0.32 cm, 1.38 ± 0.26 cm and 0.95 ± 0.23 cm respectively. The DTF and DE values reduced significantly during the time in both groups (P value |
| doi_str_mv | 10.1016/j.jcrc.2024.154621 |
| format | Article |
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Aim of the present study was to evaluate the ultra sonographic indices of diaphragm contractile activity (respiratory excursion and thickening) during mechanical ventilation with Bilevel Positive Airway Pressure (BiPAP) and Synchronized intermittent mandatory ventilation (SIMV), widely used modes in critically ill patients [1].
Eligible patients admitted to the ICU who met criteria equally divided in 2 groups; 1) BiPAP (n = 20) and 2) SIMV (n = 20). Cases of thoracic/gastric/ esophageal surgery, patients with the history of neuromuscular disorders, and who weaned from mechanical ventilation during the first 48 h after ultra sonographic recording were excluded. The right hemidiaphragm was evaluated by B- and M-mode ultrasonography to record diaphragmatic excursion (DE) and thickening fraction (DTF) [2].
In the BiPAP group, DTF values in the first, third and seventh days were 39 ± 9%, 27.8 ± 7.4% and 22 ± 6.5% and diaphragmatic excursion (DE) were 2 ± 0.31 cm, 1.35 ± 0.19 cm and 1.13 ± 0.14 cm respectively. First, third and seventh days DTF values in the SIMV group, were 32 ± 5.1%, 25 ± 4.2% and 21.5 ± 4.47%; and DE were 1.9 ± 0.32 cm, 1.38 ± 0.26 cm and 0.95 ± 0.23 cm respectively. The DTF and DE values reduced significantly during the time in both groups (P value <0.001) but there is no significant difference between two groups of the study. Diaphragmatic dysfunction (DD) defined as DTF ≤ 20%, or DE ≤ 1.5 cm, was seen in 10% of BiPAP and 15% of SIMV groups.
The DE and DTF values decreased significantly in both study groups. However, there were no significant difference between groups in this regard.
1-Supinski G, Dhr S, Callahan L. Diaphragm Dysfunction in Critical Illness. Chest 2018;153:1040–1051
2-Zambon M, Greco M, Bocchino S, et al. Assessment of diaphragmatic dysfunction in the Critically ill patient with Ultrasound: a systematic review. Intensive Care Medicine 2017;43:29–38</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2024.154621</identifier><language>eng</language><publisher>Philadelphia: Elsevier Inc</publisher><subject>Critical care ; Diaphragm ; Diaphragm (Anatomy) ; Dysfunction ; Ultrasound ; Ventilators</subject><ispartof>Journal of critical care, 2024-06, Vol.81, p.154621, Article 154621</ispartof><rights>2024</rights><rights>Copyright Elsevier Limited Jun 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/3020341870?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64389,72469</link.rule.ids></links><search><creatorcontrib>Jahromi, Golnar Sabetian</creatorcontrib><creatorcontrib>Tabatabaei, Seyyed Mohammad</creatorcontrib><creatorcontrib>Zand, Farid</creatorcontrib><creatorcontrib>Nikandish, Reza</creatorcontrib><creatorcontrib>Masjedi, Mansoor</creatorcontrib><creatorcontrib>Boldaji, Vida Naderi</creatorcontrib><title>Ultrasonographic comparison of the diaphragm function in critically ill patients with volume and pressure modes</title><title>Journal of critical care</title><description>Mechanical ventilation and the effect of respiratory muscle unloading on the diaphragm causes atrophy of the diaphragmatic muscle.
Aim of the present study was to evaluate the ultra sonographic indices of diaphragm contractile activity (respiratory excursion and thickening) during mechanical ventilation with Bilevel Positive Airway Pressure (BiPAP) and Synchronized intermittent mandatory ventilation (SIMV), widely used modes in critically ill patients [1].
Eligible patients admitted to the ICU who met criteria equally divided in 2 groups; 1) BiPAP (n = 20) and 2) SIMV (n = 20). Cases of thoracic/gastric/ esophageal surgery, patients with the history of neuromuscular disorders, and who weaned from mechanical ventilation during the first 48 h after ultra sonographic recording were excluded. The right hemidiaphragm was evaluated by B- and M-mode ultrasonography to record diaphragmatic excursion (DE) and thickening fraction (DTF) [2].
In the BiPAP group, DTF values in the first, third and seventh days were 39 ± 9%, 27.8 ± 7.4% and 22 ± 6.5% and diaphragmatic excursion (DE) were 2 ± 0.31 cm, 1.35 ± 0.19 cm and 1.13 ± 0.14 cm respectively. First, third and seventh days DTF values in the SIMV group, were 32 ± 5.1%, 25 ± 4.2% and 21.5 ± 4.47%; and DE were 1.9 ± 0.32 cm, 1.38 ± 0.26 cm and 0.95 ± 0.23 cm respectively. The DTF and DE values reduced significantly during the time in both groups (P value <0.001) but there is no significant difference between two groups of the study. Diaphragmatic dysfunction (DD) defined as DTF ≤ 20%, or DE ≤ 1.5 cm, was seen in 10% of BiPAP and 15% of SIMV groups.
The DE and DTF values decreased significantly in both study groups. However, there were no significant difference between groups in this regard.
1-Supinski G, Dhr S, Callahan L. Diaphragm Dysfunction in Critical Illness. Chest 2018;153:1040–1051
2-Zambon M, Greco M, Bocchino S, et al. Assessment of diaphragmatic dysfunction in the Critically ill patient with Ultrasound: a systematic review. 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Aim of the present study was to evaluate the ultra sonographic indices of diaphragm contractile activity (respiratory excursion and thickening) during mechanical ventilation with Bilevel Positive Airway Pressure (BiPAP) and Synchronized intermittent mandatory ventilation (SIMV), widely used modes in critically ill patients [1].
Eligible patients admitted to the ICU who met criteria equally divided in 2 groups; 1) BiPAP (n = 20) and 2) SIMV (n = 20). Cases of thoracic/gastric/ esophageal surgery, patients with the history of neuromuscular disorders, and who weaned from mechanical ventilation during the first 48 h after ultra sonographic recording were excluded. The right hemidiaphragm was evaluated by B- and M-mode ultrasonography to record diaphragmatic excursion (DE) and thickening fraction (DTF) [2].
In the BiPAP group, DTF values in the first, third and seventh days were 39 ± 9%, 27.8 ± 7.4% and 22 ± 6.5% and diaphragmatic excursion (DE) were 2 ± 0.31 cm, 1.35 ± 0.19 cm and 1.13 ± 0.14 cm respectively. First, third and seventh days DTF values in the SIMV group, were 32 ± 5.1%, 25 ± 4.2% and 21.5 ± 4.47%; and DE were 1.9 ± 0.32 cm, 1.38 ± 0.26 cm and 0.95 ± 0.23 cm respectively. The DTF and DE values reduced significantly during the time in both groups (P value <0.001) but there is no significant difference between two groups of the study. Diaphragmatic dysfunction (DD) defined as DTF ≤ 20%, or DE ≤ 1.5 cm, was seen in 10% of BiPAP and 15% of SIMV groups.
The DE and DTF values decreased significantly in both study groups. However, there were no significant difference between groups in this regard.
1-Supinski G, Dhr S, Callahan L. Diaphragm Dysfunction in Critical Illness. Chest 2018;153:1040–1051
2-Zambon M, Greco M, Bocchino S, et al. Assessment of diaphragmatic dysfunction in the Critically ill patient with Ultrasound: a systematic review. Intensive Care Medicine 2017;43:29–38</abstract><cop>Philadelphia</cop><pub>Elsevier Inc</pub><doi>10.1016/j.jcrc.2024.154621</doi></addata></record> |
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| subjects | Critical care Diaphragm Diaphragm (Anatomy) Dysfunction Ultrasound Ventilators |
| title | Ultrasonographic comparison of the diaphragm function in critically ill patients with volume and pressure modes |
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