Diaphragm Movement And Contractility Evaluation By Thoracic Ultrasound

Diaphragm Movement and Contractility Evaluation by Thoracic Ultrasound: Ultrasonography Determination of Diaphragmatic Excursion Bassel Ericsoussi, MD Pulmonary and Critical Care Fellow University of Illinois at Chicago

The Importance of the Diaphragm ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diaphragmatic Paralysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnosis of Diaphragmatic Paralysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnosis of Diaphragmatic Paralysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pleural Pressure: balloon at the lower third of the esophagus Gastric Pressure: balloon in the stomach Rib Cage movement Abdominal wall movement

Diaphragmatic Movement Evaluation with Thoracic Ultrasound ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Equipment and Technique ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diaphragm Movements and M-mode Ultrasonographic Measurements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diaphragm inspiratory time Diaphragm expiratory time Diaphragm inspiratory amplitude

Maneuver began at the end of normal expiration: Quiet Breathing (QB): Diaphragm excursion 1.5-2 cm Lower limit 0.9 cm for women and 1 cm for men Voluntary Sniffing (VS) Diaphragm excursion 2.5-3 cm Lower limit 1.6 cm in women and 1.8 cm in men “normal caudal movement of the diaphragm during inspiration” Deep Breathing (DB) Diaphragm excursion 6-7 cm Lower limit 3.7 cm for women and 4.7 cm for men

Diaphragmatic Motion Studied by M-Mode Ultrasonography Methods, Reproducibility, and Normal Values. CHEST February 2009 vol. 135 no. 2 391-400

Challenges ,[object Object],[object Object],[object Object],[object Object],[object Object]

Ultrasonographic Diagnostic Criterion for Severe Diaphragmatic Dysfunction After Cardiac Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ultrasonographic Diagnostic Criterion for Severe Diaphragmatic Dysfunction After Cardiac Surgery CHEST February 2009 vol. 135 no. 2 401-407 Diaphragm contribution to respiratory pressure severe diaphragmatic dysfunction

Ultrasonographic Diagnostic Criterion for Severe Diaphragmatic Dysfunction After Cardiac Surgery ,[object Object],[object Object],[object Object],CHEST February 2009 vol. 135 no. 2 401-407

Diaphragmatic Paralysis: The Use of M Mode Ultrasound for Diagnosis in Adults ,[object Object],[object Object],[object Object],[object Object],[object Object],Spinal Cord. 2006 Aug;44(8):505-8. Epub 2005 Dec 6.

Conclusion ,[object Object],[object Object],[object Object]

References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diaphragm Movement And Contractility Evaluation By Thoracic Ultrasound

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Diaphragm Movement And Contractility Evaluation By Thoracic Ultrasound