Abstract
To evaluate the effect of non invazive mechanical ventilation(NIMV) on diaphragmatic function in COPD exacerbation inpatients by using M-mod ultrasonography.
In 2009 COPD exacerbation inpatients who meet inclusion criterias and whom have NIMV endication were implicated in our study.Bronchodilator, antibiotherapy and systemic steroid treatment were performed to all patients.In addition to medical therapy,NIMV was applied.Before NIMV application,diaphragmatic excursion during tidal ventilation(TV), deep breathing(DB) and diaphragmatic thickness were measured by using GE Logic 7 US and 3.5MHz konveks probe.After 2 hours NIMV treatment, the same diaphragmatic parameters were measured again by the same radiology physician and by the same US.The measured values of diaphragmatic motion and thickness before and after NIMV treatment were compared by using Wilcoxon sign test.
The mean age of 37 included COPD patients was 64.56±11 years old and 34 of them were male.In our study the mean FVC and FEV1 was 2567 ml and 1342 ml respectively.Before starting NIMV the mean diaphragmatic motion during TV was 1.71±0.53 cm,during DB was 4.25±1.02 cm.After adding short time NIMV treatment,the mean diaphragmatic motion during TV increases to 2.33± 0.74 cm, during DB it was 5.25±1.26 cm.The difference between the diaphragmatic motion during TV and DB before and after the NIMV was statistically significant(p<0.0001).
M-mode ultrasonography is a non invasive and inexpensive method in evaluation of diaphragmatic motion. In our study the positive effect of short duration NIMV treatment on diaphragmatic motion in COPD exacerbation was determined.
- © 2013 ERS
