Ultrasound assessment of diaphragm thickness, contractility, and strain in healthy pediatric patients
Background Ultrasound‐based diaphragmatic assessments are becoming more common in pediatric acute care, but baseline pediatric diaphragm thickness and contractility values remain unknown. Methods We conducted a prospective, observational study of healthy children aged
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| Veröffentlicht in: | Pediatric pulmonology 2024-02, Vol.59 (2), p.433-441 |
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| creator | Glau, Christie L. Lin, Elaina E. Conlon, Thomas W. Himebauch, Adam S. Keim, Garrett P. Nishisaki, Akira |
| description | Background
Ultrasound‐based diaphragmatic assessments are becoming more common in pediatric acute care, but baseline pediatric diaphragm thickness and contractility values remain unknown.
Methods
We conducted a prospective, observational study of healthy children aged |
| doi_str_mv | 10.1002/ppul.26768 |
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Ultrasound‐based diaphragmatic assessments are becoming more common in pediatric acute care, but baseline pediatric diaphragm thickness and contractility values remain unknown.
Methods
We conducted a prospective, observational study of healthy children aged <18 years undergoing elective surgery. Diaphragm thickness at end‐expiration (Tdi‐exp), thickening fraction (DTF) and excursion were measured by ultrasound during spontaneous breathing and during mechanical ventilation. Diaphragm strain and peak strain rate were ascertained post hoc. Measurements were compared across a priori specified age groups (<1 year, 1 to <3, 3 to <6, 6 to <12, and 12 to <18 years) and with versus without mechanical ventilation.
Results
Fifty subjects were evaluated (n = 10 per age group). Baseline mean Tdi‐exp was 0.19 ± 0.04 cm, DTF 0.19 ± 0.09, excursion 1.69 ± 0.97 cm, strain −10.3 ± 4.9, peak strain rate −0.48 ± 0.21 s−1. No significant difference in Tdi‐exp or DTF was observed across age groups (p > .05). Diaphragm excursion increased with age (p < .0001). Diaphragm strain was significantly greater in the 12–17‐year age group (−14.3 ± 6.4), p = .048, but there were no age‐related differences in peak strain rate (p = .08). During mechanical ventilation, there were significant decreases in DTF 0.12 ± 0.04 (p < .0001), excursion 1.08 ± 0.31 cm (p < .0001), strain −4.60 ± 1.93 (p < .0001), and peak strain rate −0.20 ± 0.10 s−1 (p < .0001) while there was no change in Tdi‐exp 0.18 ± 0.03 cm (p = .25) when compared to baseline values.
Conclusion
Pediatric Tdi‐exp, DTF, and diaphragm peak strain rate were similar across age groups. Diaphragm excursion and strain varied across age groups. All measures of diaphragm contractility were diminished during mechanical ventilation.]]></description><identifier>ISSN: 8755-6863</identifier><identifier>EISSN: 1099-0496</identifier><identifier>DOI: 10.1002/ppul.26768</identifier><identifier>PMID: 38038168</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Age groups ; child ; diaphragm ; infant ; Pediatrics ; respiration ; respiration artificial ; Ultrasonic imaging ; ultrasound ; Ventilators</subject><ispartof>Pediatric pulmonology, 2024-02, Vol.59 (2), p.433-441</ispartof><rights>2023 Wiley Periodicals LLC.</rights><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3578-9921909d24101576051d4082aa5c4a2886430bbcff92bca06b9f529a32458a1d3</citedby><cites>FETCH-LOGICAL-c3578-9921909d24101576051d4082aa5c4a2886430bbcff92bca06b9f529a32458a1d3</cites><orcidid>0000-0003-1583-4609</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fppul.26768$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fppul.26768$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38038168$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Glau, Christie L.</creatorcontrib><creatorcontrib>Lin, Elaina E.</creatorcontrib><creatorcontrib>Conlon, Thomas W.</creatorcontrib><creatorcontrib>Himebauch, Adam S.</creatorcontrib><creatorcontrib>Keim, Garrett P.</creatorcontrib><creatorcontrib>Nishisaki, Akira</creatorcontrib><title>Ultrasound assessment of diaphragm thickness, contractility, and strain in healthy pediatric patients</title><title>Pediatric pulmonology</title><addtitle>Pediatr Pulmonol</addtitle><description><![CDATA[Background
Ultrasound‐based diaphragmatic assessments are becoming more common in pediatric acute care, but baseline pediatric diaphragm thickness and contractility values remain unknown.
Methods
We conducted a prospective, observational study of healthy children aged <18 years undergoing elective surgery. Diaphragm thickness at end‐expiration (Tdi‐exp), thickening fraction (DTF) and excursion were measured by ultrasound during spontaneous breathing and during mechanical ventilation. Diaphragm strain and peak strain rate were ascertained post hoc. Measurements were compared across a priori specified age groups (<1 year, 1 to <3, 3 to <6, 6 to <12, and 12 to <18 years) and with versus without mechanical ventilation.
Results
Fifty subjects were evaluated (n = 10 per age group). Baseline mean Tdi‐exp was 0.19 ± 0.04 cm, DTF 0.19 ± 0.09, excursion 1.69 ± 0.97 cm, strain −10.3 ± 4.9, peak strain rate −0.48 ± 0.21 s−1. No significant difference in Tdi‐exp or DTF was observed across age groups (p > .05). Diaphragm excursion increased with age (p < .0001). Diaphragm strain was significantly greater in the 12–17‐year age group (−14.3 ± 6.4), p = .048, but there were no age‐related differences in peak strain rate (p = .08). During mechanical ventilation, there were significant decreases in DTF 0.12 ± 0.04 (p < .0001), excursion 1.08 ± 0.31 cm (p < .0001), strain −4.60 ± 1.93 (p < .0001), and peak strain rate −0.20 ± 0.10 s−1 (p < .0001) while there was no change in Tdi‐exp 0.18 ± 0.03 cm (p = .25) when compared to baseline values.
Conclusion
Pediatric Tdi‐exp, DTF, and diaphragm peak strain rate were similar across age groups. Diaphragm excursion and strain varied across age groups. All measures of diaphragm contractility were diminished during mechanical ventilation.]]></description><subject>Age groups</subject><subject>child</subject><subject>diaphragm</subject><subject>infant</subject><subject>Pediatrics</subject><subject>respiration</subject><subject>respiration artificial</subject><subject>Ultrasonic imaging</subject><subject>ultrasound</subject><subject>Ventilators</subject><issn>8755-6863</issn><issn>1099-0496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LxDAQhoMoun5c_AES8CJidZI2aXIU8QsW9OCeQ5qmbrRfJimy_97oqgcPwsDAzDMPw4vQIYFzAkAvxnFqzykvudhAMwJSZlBIvolmomQs44LnO2g3hBeAtJNkG-3kAnJBuJghu2ij12GY-hrrEGwIne0jHhpcOz0uvX7ucFw689qn1Rk2Q59wE13r4uoM63QV0sD1ONXS6jYuV3i06TZ6Z_Coo0u6sI-2Gt0Ge_Dd99Di5vrp6i6bP9zeX13OM5OzUmRSUiJB1rQgQFjJgZG6AEG1ZqbQVAhe5FBVpmkkrYwGXsmGUalzWjChSZ3voZO1d_TD22RDVJ0Lxrat7u0wBUWF5AKKkhQJPf6DvgyT79N3ikrCoCzLnCXqdE0ZP4TgbaNG7zrtV4qA-gxffYavvsJP8NG3cqo6W_-iP2kngKyBd9fa1T8q9fi4mK-lH00dj54</recordid><startdate>202402</startdate><enddate>202402</enddate><creator>Glau, Christie L.</creator><creator>Lin, Elaina E.</creator><creator>Conlon, Thomas W.</creator><creator>Himebauch, Adam S.</creator><creator>Keim, Garrett P.</creator><creator>Nishisaki, Akira</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1583-4609</orcidid></search><sort><creationdate>202402</creationdate><title>Ultrasound assessment of diaphragm thickness, contractility, and strain in healthy pediatric patients</title><author>Glau, Christie L. ; Lin, Elaina E. ; Conlon, Thomas W. ; Himebauch, Adam S. ; Keim, Garrett P. ; Nishisaki, Akira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3578-9921909d24101576051d4082aa5c4a2886430bbcff92bca06b9f529a32458a1d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Age groups</topic><topic>child</topic><topic>diaphragm</topic><topic>infant</topic><topic>Pediatrics</topic><topic>respiration</topic><topic>respiration artificial</topic><topic>Ultrasonic imaging</topic><topic>ultrasound</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Glau, Christie L.</creatorcontrib><creatorcontrib>Lin, Elaina E.</creatorcontrib><creatorcontrib>Conlon, Thomas W.</creatorcontrib><creatorcontrib>Himebauch, Adam S.</creatorcontrib><creatorcontrib>Keim, Garrett P.</creatorcontrib><creatorcontrib>Nishisaki, Akira</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric pulmonology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Glau, Christie L.</au><au>Lin, Elaina E.</au><au>Conlon, Thomas W.</au><au>Himebauch, Adam S.</au><au>Keim, Garrett P.</au><au>Nishisaki, Akira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound assessment of diaphragm thickness, contractility, and strain in healthy pediatric patients</atitle><jtitle>Pediatric pulmonology</jtitle><addtitle>Pediatr Pulmonol</addtitle><date>2024-02</date><risdate>2024</risdate><volume>59</volume><issue>2</issue><spage>433</spage><epage>441</epage><pages>433-441</pages><issn>8755-6863</issn><eissn>1099-0496</eissn><abstract><![CDATA[Background
Ultrasound‐based diaphragmatic assessments are becoming more common in pediatric acute care, but baseline pediatric diaphragm thickness and contractility values remain unknown.
Methods
We conducted a prospective, observational study of healthy children aged <18 years undergoing elective surgery. Diaphragm thickness at end‐expiration (Tdi‐exp), thickening fraction (DTF) and excursion were measured by ultrasound during spontaneous breathing and during mechanical ventilation. Diaphragm strain and peak strain rate were ascertained post hoc. Measurements were compared across a priori specified age groups (<1 year, 1 to <3, 3 to <6, 6 to <12, and 12 to <18 years) and with versus without mechanical ventilation.
Results
Fifty subjects were evaluated (n = 10 per age group). Baseline mean Tdi‐exp was 0.19 ± 0.04 cm, DTF 0.19 ± 0.09, excursion 1.69 ± 0.97 cm, strain −10.3 ± 4.9, peak strain rate −0.48 ± 0.21 s−1. No significant difference in Tdi‐exp or DTF was observed across age groups (p > .05). Diaphragm excursion increased with age (p < .0001). Diaphragm strain was significantly greater in the 12–17‐year age group (−14.3 ± 6.4), p = .048, but there were no age‐related differences in peak strain rate (p = .08). During mechanical ventilation, there were significant decreases in DTF 0.12 ± 0.04 (p < .0001), excursion 1.08 ± 0.31 cm (p < .0001), strain −4.60 ± 1.93 (p < .0001), and peak strain rate −0.20 ± 0.10 s−1 (p < .0001) while there was no change in Tdi‐exp 0.18 ± 0.03 cm (p = .25) when compared to baseline values.
Conclusion
Pediatric Tdi‐exp, DTF, and diaphragm peak strain rate were similar across age groups. Diaphragm excursion and strain varied across age groups. All measures of diaphragm contractility were diminished during mechanical ventilation.]]></abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38038168</pmid><doi>10.1002/ppul.26768</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1583-4609</orcidid></addata></record> |
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| subjects | Age groups child diaphragm infant Pediatrics respiration respiration artificial Ultrasonic imaging ultrasound Ventilators |
| title | Ultrasound assessment of diaphragm thickness, contractility, and strain in healthy pediatric patients |
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