RT Journal Article
SR Electronic
T1 Ultrasound assessment of diaphragmatic function in subjects with COPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3801
DO 10.1183/13993003.congress-2016.PA3801
VO 48
IS suppl 60
A1 Marco Rossetti
A1 Paolo Marinelli
A1 Irene Turinese
A1 Marcello Di Paolo
A1 Matteo Bonini
A1 Paolo Palange
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA3801.abstract
AB Introduction: Inspiratory Capacity (IC) is an important predictor of mortality in COPD patients. Pulmonary function and lung volumes depend on diaphragmatic function which can be influenced by body position. Diaphragmatic movements can be non-invasively evaluated with ultrasound technique.Aim of the study: To evaluate the efficacy of diaphragmatic excursion (DE) in patients with COPD compared to normal subjects using IC/DE ratio as functional index, also depending on body position.Methods: Sixteen COPD subjects and sixteen healthy controls were evaluated, by two independent operators, in both standing and lying position. Each subject underwent spirometry and then three simultaneous IC and DE measurements. DE was assessed using B-mode anterior approach (Boussuges A. et al Chest. 2009 Feb;135:391-400).Results: In COPD patients, IC remained almost stable 2.23±0.62 L vs 2.29±0.67 L (p = 0.86) while DE increased from 4.40±1.16 cm to 5.14±1.06 cm (p =0.005) from standing to supine position; IC/DE changed from 0.52±0.15 to 0.45±0.12 L/cm (p =0.048). In normal subjects, IC increased from 2.74±0.72 L to 3.14±0.89 L (p = 0.06), while DE increased from 4.37±1.12 to 6.23±0.93 cm (p < 0.001) and IC/DE ratio changed from 0.63±0.12 L/cm to 0.50±0.11 L/cm (p < 0.001) from standing to supine position. The difference in IC/DE ratio between the two groups was statistically significant (p=0.001 in standing position, p=0.029 in supine position).Conclusion: Subjects with COPD showed a worse diaphragmatic function when expressed as IC/DE ratio, which becomes even less favorable in supine position. Ultrasound could be a useful tool to estimate the impact of diaphragmatic function on breathing patterns, integrating spirometric data.