Visual Patterns of Diaphragmatic Motion in Acute Respiratory Failure: A Prospective Pilot Study.

Autor: Markarian T; Department of Emergency Medicine, Assistance publique des hôpitaux de Marseille (APHM), Timone University Hospital, Aix-Marseille University, UMR 1263 (C2VN), Marseille, France., Daniel M; Department of Emergency Medicine SAMU-SMUR 974, La Réunion University Hospital, University of La Réunion, Saint-Denis de La Réunion, France., Guillemet K; Department of Emergency Medicine, Nîmes University Hospital, Montpellier University, UR UM 103 (IMAGINE), Nîmes, France., Ajavon F; Department of Emergency Medicine, Nîmes University Hospital, Montpellier University, UR UM 103 (IMAGINE), Nîmes, France., Femy F; IMPEC Federation, Paris, France.; Emergency Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.; Toxicology and Chemical Risks Department, French Armed Forces Biomedical Institute, Bretigny-Sur-Orges, France., Grandpierre RG; Department of Emergency Medicine, Nîmes University Hospital, Montpellier University, UR UM 103 (IMAGINE), Nîmes, France., Feral-Pierssens AL; SAMU 93 - Emergency Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France.; LEPS UR 3412, Université Sorbonne Paris Nord, Bobigny, France., Bobbia X; Department of Emergency Medicine, Montpellier University Hospital, Montpellier University, UR UM 103 (IMAGINE), Montpellier, France.
Jazyk: angličtina
Zdroj: Journal of clinical ultrasound : JCU [J Clin Ultrasound] 2024 Oct 29. Date of Electronic Publication: 2024 Oct 29.
DOI: 10.1002/jcu.23886
Abstrakt: Introduction: Right diaphragmatic excursion is a reliable and reproducible technique used in intensive care to assess diaphragmatic function. The aim of this study was to investigate the relationship between the appearance of diaphragmatic motion and the etiological diagnosis of patients admitted to the emergency department with acute respiratory failure (ARF).
Materials: A prospective, observational, and multicenter pilot study was conducted. All adult patients admitted in the emergency department with ARF were included. The different visual patterns of diaphragmatic motion were analyzed according to the three main etiologies of ARF encountered in emergency departments.
Results: A total of 39 adult patients were included. We observed a different visual pattern in patients with pneumonia. A sum of plateau times of less than 0.2 s predicted that the main diagnosis was pneumonia, with sensitivity = 89% 95%CI [52%; 100%], specificity = 87% 95%CI [69%; 96%].
Conclusion: Our study seems to show that the shape of diaphragmatic motion in patients with ARF secondary to pneumonia is different from that in patients with exacerbation of chronic obstructive pulmonary disease or acute heart failure.
Trial Registration: ClinicalTrials.gov: NCT04591509.
(© 2024 The Author(s). Journal of Clinical Ultrasound published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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