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Diaphragmatic ultrasound

Kamal Nain Rattan, Jasbir Singh, Poonam Dalal
With increasing use of ultrasound screening, the prenatal diagnosis of congenital diaphragmatic hernia (CDH) in better resourced areas has become the norm. However, early diagnosis is still not universal in resource-poor settings and late presentations of CDH continue. We retrospectively analysed the medical records of children operated for late-presenting CDH from 2001 to 2016 at our tertiary care centre in North India. A total of 32 patients were operated during the period with a male-to-female ratio of 3:1...
February 10, 2019: Tropical Doctor
A G Arutyunov, K V Ilyina, G P Arutyunov, E A Kolesnikova, V V Pchelin, N P Kulagina, D S Tokmin, E V Tulyakova
AIM: to study changes in the volumes of muscle, fat, and connective tissue in postmortem issue samples (autoptates) from diaphragm, right ventricle, lower limb (gastrocnemius muscle), as well as morphological changes of the diaphragm muscular structure in patients with different functional classes of heart failure (HF), and to compare them with some intravital parameters of external respiration (with maximal inspiratory pressure and its amplitude simultaneously measured by ultrasound method in particular)...
January 27, 2019: Kardiologiia
Ahmad M Taha, Nagib A Yurdi, Mohamed I Elahl, Ahmed M Abd-Elmaksoud
BACKGROUND: Both low volume interscalene and infraclavicular-subomohyoid blocks were suggested to provide shoulder analgesia with low risk of phrenic nerve block. The aim of this study was to compare the frequency of the phrenic nerve block between these two techniques. METHOD: Seventy-two patients scheduled for shoulder arthroscopy were included in this randomized controlled blind study. Before induction of general anesthesia, patients received low volume interscalene block using 5 mL of ropivacaine 0...
January 30, 2019: Acta Anaesthesiologica Scandinavica
Luigi Vetrugno, Giovanni Maria Guadagnin, Federico Barbariol, Nicola Langiano, Alberto Zangrillo, Tiziana Bove
Of the various muscles that make up the respiratory system, the diaphragm is the prima donna. In the past, only specialist research centers were able to estimate and challenge the effort of this muscle; this was achieved by measuring transdiaphragmatic pressure-an invasive technique involving a double-balloon probe inserted through the esophagus-or by measuring twitch pressure (ie, the pressure generated at the outside tip of the endotracheal tube). However, the prevalence of diaphragm dysfunction in critically ill patients requiring intubation can exceed 60% (at the time of hospital admission) and may rise to as high as 80% in patients requiring prolonged mechanical ventilation and experiencing difficult weaning...
January 4, 2019: Journal of Cardiothoracic and Vascular Anesthesia
Alberto Maffey, Alejandro Colom, Carolina Venialgo, Eduardo Acastello, Patricia Garrido, Hugo Cozzani, Cecilia Eguiguren, Alejandro Teper
INTRODUCTION: Few studies have prospectively evaluated recovery process and long-term consequences of pleural space infections. OBJECTIVE: To evaluate clinical, pulmonary, and diaphragmatic function and radiological outcome in patients hospitalized with pleural empyema. MATERIAL AND METHODS: Previously healthy patients from 6 to 16 years were enrolled. Demographic, clinical, and treatment data were registered. At hospital discharge, and every 30 days or until normalization, patients underwent a clinical evaluation, diaphragmatic ultrasound, and lung function testing...
January 23, 2019: Pediatric Pulmonology
Haytham H Eltrabili, Ahmed M Hasanin, Mahmoud S Soliman, Ahmed M Lotfy, Walid I Hamimy, Ahmed M Mukhtar
BACKGROUND: Sepsis-induced diaphragmatic dysfunction is one of the main risk factors of failure to liberate patients from mechanical ventilation. Several studies addressed diaphragmatic ultrasound as a valuable tool in the assessment of diaphragmatic function during liberation from mechanical ventilation in different populations. However, none of these studies examined the use of diaphragmatic ultrasound to predict failure of liberation from mechanical ventilation in subjects with sepsis METHODS: A prospective observational study was done with subjects on mechanical ventilation and with abdominal sepsis...
January 22, 2019: Respiratory Care
Iuri Corsini, Niccolò Parri, Caterina Coviello, Valentina Leonardi, Carlo Dani
Congenital diaphragmatic hernia (CDH) occurs in approximately 1 in 2500 to 5000 infants. The use of lung ultrasound (LUS) for its diagnosis has been reported in only two case reports. The aim of this study was to report the LUS pattern of CDH in a case series of infants with respiratory distress. This case series was part of a cohort enrolled in a larger prospective observational study. LUS was performed at the point-of-care during the first 24 h of life of the neonates and its operation time was measured...
January 21, 2019: European Journal of Pediatrics
Douglas Evans, Deborah Shure, Linda Clark, Gerard J Criner, Martin Dres, Marcelo Gama de Abreu, Franco Laghi, David McDonagh, Basil Petrof, Teresa Nelson, Thomas Similowski
BACKGROUND: Mechanical ventilation (MV) is a life-saving technology that restores or assists breathing. Like any treatment, MV has side effects. In some patients it can cause diaphragmatic atrophy, injury, and dysfunction (ventilator-induced diaphragmatic dysfunction, VIDD). Accumulating evidence suggests that VIDD makes weaning from MV difficult, which involves increased morbidity and mortality. METHODS AND ANALYSIS: This paper describes the protocol of a randomized, controlled, open-label, multicenter trial that is designed to investigate the safety and effectiveness of a novel therapy, temporary transvenous diaphragm pacing (TTVDP), to improve weaning from MV in up to 88 mechanically ventilated adult patients who have failed at least two spontaneous breathing trials over at least 7 days...
January 17, 2019: Trials
Amanda Veiga-Fernández, Laura Joigneau Prieto, Teresa Álvarez, Yolanda Ruiz, Ricardo Pérez, Francisco Gámez, Virginia Ortega Abad, Fátima Yllana, Juan De León-Luis
Early onset Marfan syndrome is the most severe form of Marfan syndrome diagnosed during perinatal period. Early onset Marfan syndrome is associated with high mortality rates, usually within the first 2 years of life. First, we present a case of prenatally diagnosed early onset Marfan syndrome in a dichorionic diamniotic twin pregnancy, where suspicion was raised at 35 weeks of gestation. Ultrasound and fetal magnetic resonance imaging were used to assess prenatal findings in the affected fetus. She presented right diaphragmatic eventration, elongation of humerus and femur and subluxation of the crystalline lens...
January 17, 2019: Journal of Maternal-fetal & Neonatal Medicine
Andrea Boccatonda, Valentina Decorato, Giulio Cocco, Stefano Marinari, Cosima Schiavone
Background: Some previous works have tested LUS use in diagnosing and monitoring interstitial lung diseases. B-lines are main sonographic signs for interstitial diseases. Increasing evidences suggest that dyspnea and impaired exercise capacity in IPF patients can be related, at least in part, to respiratory muscle dysfunction, in particular to diaphragm functionality. Both B-mode and M-mode ultrasound techniques have been employed to assess diaphragm excursion (DE), which measures the distance that the diaphragm is able to move during the respiratory cycle...
2019: Multidisciplinary Respiratory Medicine
Takahiro Hosokawa, Yoshitake Yamada, Hiroaki Takahashi, Yutaka Tanami, Yumiko Sato, Tetsuya Ishimaru, Yujiro Tanaka, Hiroshi Kawashima, Mayumi Hosokawa, Eiji Oguma
OBJECTIVES: To compare defect sizes in congenital diaphragmatic hernia (CDH) measured by postnatal ultrasound (US) between neonates who underwent thoracoscopic surgery and neonates who underwent open surgery and between neonates who underwent primary repair and those who underwent patch repair; additionally, to compare the accuracy of US diagnosis with that of surgical diagnosis for the location of the diaphragmatic hernia and the hernial contents. METHODS: We included 8 neonates who underwent preoperative US evaluations of CDH...
January 16, 2019: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Xiuxia Bao, Juanjuan Huang, Haorong Feng, Yuying Qian, Yajie Wang, Qunying Zhang, Huansheng Hu, Xianghe Wang
BACKGROUND AND OBJECTIVES: Diaphragmatic paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. METHODS: Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0...
January 2019: Regional Anesthesia and Pain Medicine
Edward R Oliver, Suzanne E DeBari, Samantha E Adams, Ryne A Didier, Steven C Horii, Teresa Victoria, Holly L Hedrick, N Scott Adzick, Lori J Howell, Julie S Moldenhauer, Beverly G Coleman
BACKGROUND: The presence of a hernia sac in congenital diaphragmatic hernia (CDH) has been reported to be associated with higher lung volumes and better postnatal outcomes. OBJECTIVE: To compare prenatal imaging (ultrasound and MRI) prognostic measurements and postnatal outcomes of CDH with and without hernia sac. MATERIALS AND METHODS: We performed database searches from January 2008 to March 2017 for surgically proven cases of CDH with and without hernia sac...
January 11, 2019: Pediatric Radiology
Nimrah Abbasi, Greg Ryan, Anthony Johnson, Magda Sanz Cortes, Haleh Sangi-Haghpeykar, Xiang Y Ye, Prakesh S Shah, Alexandra Benachi, Julien Saada, Rodrigo Ruano
OBJECTIVE: To determine the antenatal sonographic lung area measurement method in left congenital diaphragmatic hernia (CDH) with the highest interrater agreement among North American Fetal Therapy Network (NAFTNet) centers within and outside the fetoscopic tracheal occlusion (FETO) consortium and in comparison with a European "expert" reviewer (ER). METHODS: Nineteen members from nine FETO consortium centers and 29 reviewers from 17 non-FETO centers reviewed ultrasound clips of the chest from 13 fetuses with isolated left CDH and were asked to select a static plane for lung area measurement using anteroposterior (AP), longest, and trace methods...
January 7, 2019: Prenatal Diagnosis
Abdallah Fayssoil, Cendrine Chaffaut, Adam Ogna, Tanya Stojkovic, Laure Lamothe, Dominique Mompoint, Paris Meng, Helene Prigent, Bernard Clair, Anthony Behin, Pascal Laforet, Guillaume Bassez, Robert Carlier, David Orlikowski, Helge Amthor, Susana Quijano Roy, Pascal Crenn, Sylvie Chevret, Bruno Eymard, Frederic Lofaso, Djillali Annane
BACKGROUND: Duchenne muscular dystrophy (DMD) is an X-linked recessive genetic muscle disorder. Respiratory muscle function is classically affected in this disease. Ultrasound recently emerged as a non-invasive tool to assess diaphragm function. However, there are only a few studies using diaphragm ultrasound (US) in DMD. PURPOSE: We aimed to assess diaphragm ultrasound patterns in DMD, their relationship with age and their association with home mechanical ventilation (HMV)...
December 8, 2018: Journal of Neuromuscular Diseases
Scarlata Simone, Mancini Damiana, Laudisio Alice, Antonelli Incalzi Raffaele
We aimed at testing M-mode ultrasound diaphragmatic thickness reproducibility and its clinical correlates in healthy volunteers. Sixty-six consecutive healthy volunteers were considered eligible, and enrolled in the study. During a single visit, all participants received three M-mode and B-mode ultrasound evaluations of Diaphragmatic Thickness (DT). We then proceeded to calculate the thickness difference and assess the association of ultrasonographic measurements with demographic and anthropometric data. Variables associated through univariate analyses were entered in multivariable models, and Intraclass Correlation Coefficient (ICC) was performed in order to determine intra- and inter-observer reproducibility...
December 13, 2018: Respiratory Physiology & Neurobiology
A Armenise, R S Boysen, E Rudloff, L Neri, G Spattini, E Storti
OBJECTIVE: To describe the technique and findings of the 'veterinary focused assessment with sonography for trauma-airway, breathing, circulation, disability and exposure' protocol in dogs suffering from trauma. MATERIALS AND METHODS: Prospective observational study on a new point-of-care ultrasound protocol on 64 dogs suffering from trauma and comparison of findings with radiology. RESULTS: Comparison of the results of this new ultrasound protocol for trauma patients with radiography findings for pneumothorax, pleural effusion, alveolar-interstitial syndrome and abdominal effusion revealed positive agreement of 89, 83, 100 and 87% and negative agreement of 76, 83, 76 and 92%, respectively...
December 13, 2018: Journal of Small Animal Practice
Lisandra Stein Bernardes, Juliana Fontan Ottolia, Marina Cecchini, Antônio Gomes de Amorim Filho, Manoel Jacobsen Teixeira, Rossana Pulcineli Vieira Francisco, Daniel Ciampi de Andrade
Introduction: Although pain facial assessment is routinely performed in term and preterm newborns by the use of facial expression-based tools such as the Neonatal Facial Coding System, the assessment of pain during the intrauterine life has not been extensively explored. Objective: Describe for the first time, an experimental model to assess and quantify responses due to acute pain in fetuses undergoing anaesthesia for intrauterine surgery recorded by high-resolution 4D ultrasound machines...
September 2018: Pain Reports (Baltimore, Md.)
Ramona Dolscheid-Pommerich, Alexander Kreuzer, Ingo Graeff, Birgit Stoffel-Wagner, Andreas Mueller, Florian Kipfmueller
Background Extracorporeal membrane oxygenation procedure (ECMO) has been established in the therapy of respiratory insufficient infants with congenital diaphragmatic hernia (CDH). In CDH newborns, a delay in transfer to an ECMO center is associated with a sharp increase in mortality. Predictive factors for ECMO support are urgently needed. We evaluated routine parameters of the first blood withdrawal after birth in CDH infants, hypothesizing that early signs in bone marrow affecting hematology parameters for early regulation of potentially post birth hypoxia are predictive factors for ECMO support...
December 4, 2018: Annals of Clinical Biochemistry
J Ricoy, N Rodríguez-Núñez, J M Álvarez-Dobaño, M E Toubes, V Riveiro, L Valdés
The diaphragm is the main breathing muscle and contraction of the diaphragm is vital for ventilation so any disease that interferes with diaphragmatic innervation, contractile muscle function, or mechanical coupling to the chest wall can cause diaphragm dysfunction. Diaphragm dysfunction is associated with dyspnoea, intolerance to exercise, sleep disturbances, hypersomnia, with a potential impact on survival. Diagnosis of diaphragm dysfunction is based on static and dynamic imaging tests (especially ultrasound) and pulmonary function and phrenic nerve stimulation tests...
November 30, 2018: Pulmonology
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