Correction of Diaphragm Dysfunction in Patients With Chronic Obstructive Pulmonary Disease

Men'shikova,; Меньшикова, И. Г.; Перлей,; Perley, Vitaliy; Квасникова,; Kvasnikova, Yuliya; Скляр,; Sklyar, I. V.; Магаляс,; Magalyas, E.V.

doi:10.12737/article_5935fca0ee2974.18739498

Bulletin Physiology and Pathology of Respiration

2017

DOI: 10.12737/article_5935fca0ee2974.18739498

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Correction of Diaphragm Dysfunction in Patients With Chronic Obstructive Pulmonary Disease

Men'shikova Men'shikova¹,

И. Г. Меньшикова²,

Перлей Перлей³

et al.

Abstract: Федерации, 197022, г. Санкт-Петербург, ул. Льва Толстого, 6- University, 6-8 Lʹva Tolstogo Str., Saint Petersburg, 197022, Russian Federation The aim of the study was to examine the influence of telmisartan on the condition of the diaphragm in patients with chronic obstructive pulmonary disease (COPD) at the stage of compensated chronic pulmonary heart (CPH). We examined 30 patients with COPD, complicated with CPH, who had the examination of pulmonary and intracardiac hemodynamics and the functional state… Show more

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Interrelation of Indicators of the Functional State of the Diaphragm and Pulmonary Hemodynamics in Patients With Chronic Obstructive Pulmonary Disease

Меньшикова¹,

Перлей²,

Perley³

et al. 2018

Bulletin Physiology and Pathology of Respiration

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The aim of the study was to study the correlation between the indices of the functional state of the diaphragm and pulmonary hemodynamics in COPD patients at different stages of chronic pulmonary heart (CPH). 79 patients with COPD were examined. Patients were divided into 2 groups, taking into account the pulmonary artery pressure and the presence of clinical signs of right ventricular failure. The first group included 40 COPD patients complicated by compensated CPH; the second group included 39 patients with decompensated CPH. A complex examination of intracardiac hemodynamics and functional state of the diaphragm was carried out at the XD-11 XE device PHILIPS (USA). The following results were obtained: in patients with compensated CPH there was an increase in the thickness of the diaphragm, a decrease in the diaphragm mobility during tidal and forced breathing, and an increase in the rate of contraction of the diaphragm during tidal and forced breathing. Patients with decompensated CPH were found to have an increase in the thickness of the diaphragm, a sharp decrease in the diaphragm excursion during tidal and forced breathing, a decrease in the fraction of thickening of the muscular part of the diaphragm. The correlation analysis revealed the most informative ultrasound indices of the impairment of the functional state of the diaphragm in patients with COPD, significantly associated with pulmonary hemodynamic indices: diaphragm excursion during tidal and forced breathing, relaxation rate of the diaphragm muscle, thickness and fraction of thickening of the muscular part of the diaphragm. Determination of the functional state of the diaphragm in patients with COPD allows an early detection of signs of respiratory muscle dysfunction, a timely appointment of corrective therapy, and prevention of the development and progression of pulmonary-cardiac failure.

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Interrelation of Indicators of the Functional State of the Diaphragm and Pulmonary Hemodynamics in Patients With Chronic Obstructive Pulmonary Disease

Меньшикова¹,

Перлей²,

Perley³

et al. 2018

Bulletin Physiology and Pathology of Respiration

View full text Add to dashboard Cite

show abstract

Diagnostics of disturbances in the functional state of the diaphragm in patients with chronic obstructive pulmonary disease after COVID-19

Menshikova,

Magalyas,

Sklyar

2023

Bûlletenʹ fiziologii i patologii dyhaniâ

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Aim. Assessment of the functional state of the diaphragm in patients with COPD who underwent COVID-19.Materials and methods. The study included 35 patients with COPD complicated by compensated chronic cor pulmonale (CCP): group 1 included 15 patients with COPD who had COVID-19, group 2 included 20 patients with COPD. Patients were examined 3 months after suffering COVID-19. The functional state of the diaphragm was studied using the VIVID S70N ultrasound diagnostic system.Results. The greatest decrease in the diaphragm dome height was detected in the 1st group (p=0.001). The excursion of the diaphragm during quiet breathing was increased in both groups, in the 2nd group the indicator was 11% more than in the 1st group. The diaphragm excursion during forced breathing was reduced in the 1st group (p=0.02). The rate of diaphragm excursion during inhalation and exhalation during quiet and forced breathing in both groups was significantly increased compared to the control group. However, in the 1st group, the rate of diaphragm excursion on expiration was 49% higher. These changes may indicate respiratory muscle fatigue in COPD patients who have had COVID-19. The thickness of the muscular part of the diaphragm during inhalation and exhalation during quiet breathing in both groups compared to the control group was significantly higher. These indicators in both groups did not significantly differ from each other. There was a decrease in the thickening fraction of the muscular part of the diaphragm during calm (p=0.01) and forced breathing (p=0.001) in both groups, which indicates the onset of fatigue of the muscles of the diaphragm in the 2nd group and the initial development of weakness of the diaphragm in the 1st group who had the greatest decrease in this indicator during forced breathing.Conclusion. Ultrasonic diagnostic methods significantly expand the possibilities for assessing the functional state of the diaphragm. Patients with COPD who have undergone COVID-19 are characterized by a significant increase in the thickness of the diaphragm, limitation of its mobility, and a slowdown in the rate of relaxation of the muscular part of the diaphragm.

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Correction of Diaphragm Dysfunction in Patients With Chronic Obstructive Pulmonary Disease

Cited by 2 publications

References 1 publication

Interrelation of Indicators of the Functional State of the Diaphragm and Pulmonary Hemodynamics in Patients With Chronic Obstructive Pulmonary Disease

Interrelation of Indicators of the Functional State of the Diaphragm and Pulmonary Hemodynamics in Patients With Chronic Obstructive Pulmonary Disease

Diagnostics of disturbances in the functional state of the diaphragm in patients with chronic obstructive pulmonary disease after COVID-19

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