TY - JOUR T1 - Use of a calcium sensitizer to improve diaphragmatic motility in difficult weaning JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA3800 VL - 48 IS - suppl 60 SP - PA3800 AU - Lucia Morelli AU - Claudia Serra AU - Mario Guarino AU - Fabio Numis AU - Ilaria Vernoni AU - Imma Cortile AU - Luisa Isabella Siniscalchi AU - Rita Lebano Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA3800.abstract N2 - Diaphragm muscle weakness appear in COPD with a difficult weaning from mechanical ventilation.The calcium sensitizer Levosimendan(Levo) enhances the force-generating capacity of isolated diaphragm fibers (1) We found with bedside US (bUS) that Levo improved diaphragmatic excursion (E) in COPD patients.Materials and Methods52 ECOPD (type II) pts (age 66 ± 15 36f Apache II max 16)to need for a trial of NIV.We excluded pts with CHF, sepsis, paralysis.bUS was carried out by two operators , double-blind with 3.5-5 MHz convex probe positioned in the right subcostal transversely at the level of midclavicular line with the patient placed at 45°. We used B Mode for the Dome and M Mode for the inspiratory T in sec.(Ti), expiratory T (Te) and the E in( cm) in agreement with literature data (2) In 35 pts with difficult weaning ( E<1,2cm -Time of weaning (Tw) >72 hours) fig1, we used Levo (40 mg/kg bolus followed by 0.1/0.2mg/kg/mg )fig2 , monitoring the E with US, and finally we had a possible weaningConclusions: A rapidily detection of diaphragmatic dysfunction with bUS in COPD is useful in the changes of the times and modes of NIV and in use drugs to increase diaphragmatic E to have faster weaning and rapidily discharge from ED 1)Doorduin J et al.Am J Resp Crit Care Med. Jan 2012vol 185 pp 90-95. 2)A Testa,G Soldati et: Ultrasound Med Biol vol 37n1pp44-52 2011. ER -