Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements
Background There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) p...
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| Format: | Article |
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The Korean Academy of Tuberculosis and Respiratory Diseases
2024-01-01
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| Series: | Tuberculosis and Respiratory Diseases |
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| Online Access: | http://e-trd.org/upload/pdf/trd-2023-0030.pdf |
| _version_ | 1797370444006817792 |
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| author | Hend M. Esmaeel Kamal A. Atta Safiya khalaf Doaa Gadallah |
| author_facet | Hend M. Esmaeel Kamal A. Atta Safiya khalaf Doaa Gadallah |
| author_sort | Hend M. Esmaeel |
| collection | DOAJ |
| description | Background There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients. |
| first_indexed | 2024-03-08T18:01:39Z |
| format | Article |
| id | doaj.art-ae67c9a4d6d24623b27648e983728691 |
| institution | Directory Open Access Journal |
| issn | 1738-3536 2005-6184 |
| language | English |
| last_indexed | 2024-03-08T18:01:39Z |
| publishDate | 2024-01-01 |
| publisher | The Korean Academy of Tuberculosis and Respiratory Diseases |
| record_format | Article |
| series | Tuberculosis and Respiratory Diseases |
| spelling | doaj.art-ae67c9a4d6d24623b27648e9837286912024-01-02T01:02:19ZengThe Korean Academy of Tuberculosis and Respiratory DiseasesTuberculosis and Respiratory Diseases1738-35362005-61842024-01-01871809010.4046/trd.2023.00304844Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic MeasurementsHend M. Esmaeel0Kamal A. Atta1Safiya khalaf2Doaa Gadallah3 Department of Chest Diseases and Tuberculosis, Faculty of Medicine Sohag University, Sohag, Egypt Department of Chest Diseases and Tuberculosis, Faculty of Medicine Sohag University, Sohag, Egypt Department of Chest Diseases and Tuberculosis, Faculty of Medicine Sohag University, Sohag, Egypt Department of Chest Diseases and Tuberculosis, Faculty of Medicine Sohag University, Sohag, EgyptBackground There are many methods of evaluating diaphragmatic function, including trans-diaphragmatic pressure measurements, which are considered the key rule of diagnosis. We studied the clinical usefulness of chest ultrasonography in evaluating stable chronic obstructive pulmonary disease (COPD) patients and those in exacerbation, focusing on diaphragmatic measurements and their correlation with spirometry and other clinical parameters. Methods In a prospective case-control study, we enrolled 100 COPD patients divided into 40 stable COPD patients and 60 patients with exacerbation. The analysis included 20 age-matched controls. In addition to the clinical assessment of the study population, radiological evaluation included chest radiographs and chest computed tomography. Transthoracic ultrasonography (TUS) was performed for all included subjects. Results Multiple A lines (more than 3) were more frequent in COPD exacerbation than in stable patients, as was the case for B-lines. TUS significantly showed high specificity, negative predictive value, positive predictive value, and accuracy in detecting pleural effusion, consolidation, pneumothorax, and lung mass. Diaphragmatic measurements were significantly lower among stable COPD subjects than healthy controls. Diaphragmatic thickness and excursion displayed a significant negative correlation with body mass index and the dyspnea scale, and a positive correlation with spirometry measures. Patients in Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D showed lower diaphragmatic measurements (thickness and excursion). Conclusion The TUS of COPD patients both in stable and exacerbated conditions and the assessment of diaphragm excursion and thickness by TUS in COPD patients and their correlations to disease-related factors proved informative and paved the way for the better management of COPD patients.http://e-trd.org/upload/pdf/trd-2023-0030.pdfchronic obstructive pulmonary diseasetransthoracic chest ultrasounddiaphragm thicknessdiaphragm excrusion |
| spellingShingle | Hend M. Esmaeel Kamal A. Atta Safiya khalaf Doaa Gadallah Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements Tuberculosis and Respiratory Diseases chronic obstructive pulmonary disease transthoracic chest ultrasound diaphragm thickness diaphragm excrusion |
| title | Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements |
| title_full | Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements |
| title_fullStr | Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements |
| title_full_unstemmed | Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements |
| title_short | Clinical Utility of Chest Sonography in Chronic Obstructive Pulmonary Disease Patients Focusing on Diaphragmatic Measurements |
| title_sort | clinical utility of chest sonography in chronic obstructive pulmonary disease patients focusing on diaphragmatic measurements |
| topic | chronic obstructive pulmonary disease transthoracic chest ultrasound diaphragm thickness diaphragm excrusion |
| url | http://e-trd.org/upload/pdf/trd-2023-0030.pdf |
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