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

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

Journal

Respiratory research
ISSN: 1465-993X
Titre abrégé: Respir Res
Pays: England
ID NLM: 101090633

Informations de publication

Date de publication:
28 Oct 2023
Historique:
received: 07 06 2023
accepted: 23 10 2023
medline: 30 10 2023
pubmed: 29 10 2023
entrez: 29 10 2023
Statut: epublish

Résumé

The 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. We 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. 24 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. The 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.

Identifiants

pubmed: 37898765
doi: 10.1186/s12931-023-02577-1
pii: 10.1186/s12931-023-02577-1
pmc: PMC10613389
doi:

Types de publication

Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

259

Informations de copyright

© 2023. The Author(s).

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Auteurs

Jules Milesi (J)

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.

Alain Boussuges (A)

Pulmonary Function Testing Laboratory, APHM, Aix-Marseille University, Marseille, France.

Paul Habert (P)

Department of Radiology, APHM, Aix-Marseille University, Marseille, France.
LIIE, Aix-Marseille University, Marseille, France.
CERIMED, Aix-Marseille University, Marseille, France.

Julien Bermudez (J)

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.

Martine Reynaud-Gaubert (M)

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.

Stéphane Delliaux (S)

Pulmonary Function Testing Laboratory, APHM, Aix-Marseille University, Marseille, France.

Fabienne Bregeon (F)

Pulmonary Function Testing Laboratory, APHM, Aix-Marseille University, Marseille, France.

Benjamin Coiffard (B)

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. bcoiffard.aphm@gmail.com.

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