B-mode ultrasound assessment of diaphragm structure and function in patients with COPD

Michael R. Baria, Leili Shahgholi, Eric James Sorenson, Caitlin J. Harper, Kaiser G. Lim, Jeffrey A. Strommen, Carl D. Mottram, Andrea Boon

Research output: Contribution to journalArticle

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Abstract

CONCLUSIONS: In patients with COPD presenting for evaluation of coexisting neuromuscular respiratory weakness, the same values established for healthy control subjects serve as the baseline for comparison. This knowledge expands the role of ultrasound in evaluating neuromuscular disease in patients with COPD.

BACKGROUND: Electromyographic evaluation of diaphragmatic neuromuscular disease in patients with COPD is technically difficult and potentially high risk. Defining standard values for diaphragm thickness and thickening ratio using B-mode ultrasound may provide a simpler, safer means of evaluating these patients.

METHODS: Fifty patients with a diagnosis of COPD and FEV1< 70% underwent B-mode ultrasound. Three images were captured both at end expiration (Tmin) and at maximal inspiration (Tmax). The thickening ratio was calculated as (Tmax/Tmin), and each set of values was averaged. Findings were compared with a database of 150 healthy control subjects.

RESULTS: There was no significant difference in diaphragm thickness or thickening ratio between sides within groups (control subjects or patients with COPD) or between groups with the exception of the subgroup with severe air trapping (residual volume > 200%), in which the only difference was that the thickening ratio was higher on the left (P = .0045).

Original languageEnglish (US)
Pages (from-to)680-685
Number of pages6
JournalChest
Volume146
Issue number3
DOIs
StatePublished - Sep 1 2014

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Diaphragm
Chronic Obstructive Pulmonary Disease
Neuromuscular Diseases
Healthy Volunteers

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

B-mode ultrasound assessment of diaphragm structure and function in patients with COPD. / Baria, Michael R.; Shahgholi, Leili; Sorenson, Eric James; Harper, Caitlin J.; Lim, Kaiser G.; Strommen, Jeffrey A.; Mottram, Carl D.; Boon, Andrea.

In: Chest, Vol. 146, No. 3, 01.09.2014, p. 680-685.

Research output: Contribution to journalArticle

Baria, MR, Shahgholi, L, Sorenson, EJ, Harper, CJ, Lim, KG, Strommen, JA, Mottram, CD & Boon, A 2014, 'B-mode ultrasound assessment of diaphragm structure and function in patients with COPD', Chest, vol. 146, no. 3, pp. 680-685. https://doi.org/10.1378/chest.13-2306
Baria, Michael R. ; Shahgholi, Leili ; Sorenson, Eric James ; Harper, Caitlin J. ; Lim, Kaiser G. ; Strommen, Jeffrey A. ; Mottram, Carl D. ; Boon, Andrea. / B-mode ultrasound assessment of diaphragm structure and function in patients with COPD. In: Chest. 2014 ; Vol. 146, No. 3. pp. 680-685.
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N2 - CONCLUSIONS: In patients with COPD presenting for evaluation of coexisting neuromuscular respiratory weakness, the same values established for healthy control subjects serve as the baseline for comparison. This knowledge expands the role of ultrasound in evaluating neuromuscular disease in patients with COPD.BACKGROUND: Electromyographic evaluation of diaphragmatic neuromuscular disease in patients with COPD is technically difficult and potentially high risk. Defining standard values for diaphragm thickness and thickening ratio using B-mode ultrasound may provide a simpler, safer means of evaluating these patients.METHODS: Fifty patients with a diagnosis of COPD and FEV1< 70% underwent B-mode ultrasound. Three images were captured both at end expiration (Tmin) and at maximal inspiration (Tmax). The thickening ratio was calculated as (Tmax/Tmin), and each set of values was averaged. Findings were compared with a database of 150 healthy control subjects.RESULTS: There was no significant difference in diaphragm thickness or thickening ratio between sides within groups (control subjects or patients with COPD) or between groups with the exception of the subgroup with severe air trapping (residual volume > 200%), in which the only difference was that the thickening ratio was higher on the left (P = .0045).

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