Ultrasound evaluation of diaphragmatic function in patients with idiopathic pulmonary fibrosis: a retrospective observational study

Respiratory Research

Study Protocol

Paul Habert¹  Julien Bermudez²  Benjamin Coiffard²  Jules Milesi²  Martine Reynaud-Gaubert²  Alain Boussuges³  Stéphane Delliaux³  Fabienne Bregeon³ 

[1] Department of Radiology, APHM, Aix-Marseille University, Marseille, France;LIIE, Aix-Marseille University, Marseille, France;CERIMED, Aix-Marseille University, Marseille, France;Department of Respiratory Medicine and Lung Transplantation, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Nord, Aix-Marseille University, Chemin des Bourrely, 13015, Marseille, France;Pulmonary Function Testing Laboratory, APHM, Aix-Marseille University, Marseille, France;

关键词: Diaphragm;    Ultrasonography;    Idiopathic pulmonary fibrosis;    Lung diseases;    Physiology;    Respiratory physiological phenomena;    Musculoskeletal physiological phenomena;    Tomography;    X-Ray computed;    Respiratory function tests;   

DOI  :  10.1186/s12931-023-02577-1

 received in 2023-06-07, accepted in 2023-10-23,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionThe diaphragm function assessed by ultrasound has been well-studied in COPD, asthma, and intensive care. However, there are only a few studies on diffuse interstitial lung disease, while dyspnea and quality of life are major issues in the management that may depend on the diaphragm.MethodsWe retrospectively included idiopathic pulmonary fibrosis (IPF) patients followed in our center (Marseille, France) between January 2020 and February 2023 who underwent diaphragmatic ultrasound. Our objectives were to describe the diaphragmatic function of IPFs compared to healthy controls and to correlate with clinical, functional, and lung density on CT-scan.Results24 IPF patients and 157 controls were included. The diaphragmatic amplitude in IPF was increased at rest (median of 2.20 cm vs 1.88 cm on the right, p < 0.007, and 2.30 cm vs 1.91 cm on the left, p < 0.03, in IPF and controls respectively) and decreased in deep breathing (median of 4.85 cm vs 5.45 cm on the right, p < 0.009, and 5.10 cm vs 5.65 cm on the left, p < 0.046, in IPF and controls respectively). Diaphragmatic thickness was significantly reduced at rest on the right side (median of 1.75 mm vs 2.00 mm, p < 0.02, in IPF and controls respectively) and in deep breathing on both sides compared to controls (mean of 3.82 mm vs 4.15 mm on the right, p < 0.02, and 3.53 mm vs 3.94 mm, on the left, p < 0.009, in IPF and controls respectively). Diaphragmatic amplitude in deep breathing was moderate to strongly correlated with FVC, DLCO, and 6MWT and negatively correlated with the dyspnea and lung density on CT scan.ConclusionThe diaphragmatic amplitude and thickness were impaired in IPF compared to controls. Diaphragmatic amplitude is the parameter best correlated with clinical, functional, and lung density criteria. Further studies are needed to determine if diaphragmatic amplitude can be a prognostic factor in IPF.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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