Respiratory failure due to diaphragm paralysis after brachial plexus injury diagnosed by point-of-care ultrasound

Yajima, Wataru; Yoshida, Takuo; Kondo, Tatsuya; Uzura, Masahiko

doi:10.1136/bcr-2021-246923

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…We found four case reports describing the identification of hemidiaphragmatic dysfunction with DUS. The underlying causes were phrenic nerve paralysis, dermatomyositis exacerbation, brachial plexus damage and amyotrophic lateral sclerosis, but diaphragm dysfunction assessment was the main finding that led to the correct diagnosis [63,[77][78][79].…”

Section: Diaphragm Ultra-sound (Dus)mentioning

confidence: 99%

The Role of Pocus in Acute Respiratory Failure: A Narrative Review on Airway and Breathing Assessment

Sartini,

Ferrari,

Cutuli

et al. 2024

JCM

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Acute respiratory failure (ARF) is a challenging condition that clinicians, especially in emergency settings, have to face frequently. Especially in emergency settings, many underlying diseases can lead to ARF and life-threatening conditions have to be promptly assessed and correctly treated to avoid unfavorable outcomes. In recent years, point-of-care ultrasound (POCUS) gained growing consideration due to its bedside utilization, reliability and reproducibility even in emergency settings especially in unstable patients. Research on POCUS application to assess ARF has been largely reported mainly with observational studies showing heterogeneous results from many different applications. This narrative review describes the wide potentiality of POCUS to face airways and breathing life-threatening conditions such as upper airway management, pulmonary and pleural pathologies and diaphragm impairment. We conducted extensive research of the literature to report from major studies to case reports deemed useful in practical clinical utilization of POCUS in ARF. Due to the huge amount of the literature found, we focused on airways and breathing assessment trying to systematize the evidence according to clinical care of ARF in emergency settings. Further studies, possibly trials, should determine how POCUS is crucial in clinical practice in terms of standard of care improvements, patient safety and cost-benefit analysis.

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Section: Diaphragm Ultra-sound (Dus)mentioning

confidence: 99%

The Role of Pocus in Acute Respiratory Failure: A Narrative Review on Airway and Breathing Assessment

Sartini,

Ferrari,

Cutuli

et al. 2024

JCM

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“…Stroke can also be a cause of diaphragm paralysis, especially when involving the brain stem. Ultrasound assessment of diaphragm motility and thickness can be useful to diagnose this condition and monitor its evolution [ 169 , 170 , 171 ]. Respiratory symptom severity is generally related to the degree of dysfunction [ 169 , 170 , 171 ].…”

Section: Diaphragm Ultrasound In Specific Clinical Situations or Dise...mentioning

confidence: 99%

“…Ultrasound assessment of diaphragm motility and thickness can be useful to diagnose this condition and monitor its evolution [ 169 , 170 , 171 ]. Respiratory symptom severity is generally related to the degree of dysfunction [ 169 , 170 , 171 ].…”

Section: Diaphragm Ultrasound In Specific Clinical Situations or Dise...mentioning

confidence: 99%

Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients

Siniscalchi,

Nouvenne,

Cerundolo

et al. 2024

Geriatrics

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Diaphragm muscle dysfunction is increasingly recognized as a fundamental marker of several age-related diseases and conditions including chronic obstructive pulmonary disease, heart failure and critical illness with respiratory failure. In older individuals with physical frailty and sarcopenia, the loss of muscle mass and function may also involve the diaphragm, contributing to respiratory dysfunction. Ultrasound has recently emerged as a feasible and reliable strategy to visualize diaphragm structure and function. In particular, it can help to predict the timing of extubation in patients undergoing mechanical ventilation in intensive care units (ICUs). Ultrasonographic evaluation of diaphragmatic function is relatively cheap, safe and quick and can provide useful information for real-time monitoring of respiratory function. In this review, we aim to present the current state of scientific evidence on the usefulness of ultrasound in the assessment of diaphragm dysfunction in different clinical settings, with a particular focus on older patients. We highlight the importance of the qualitative information gathered by ultrasound to assess the integrity, excursion, thickness and thickening of the diaphragm. The implementation of bedside diaphragm ultrasound could be useful for improving the quality and appropriateness of care, especially in older subjects with sarcopenia who experience acute respiratory failure, not only in the ICU setting.

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“…The position difference between diaphragmatic contraction and relaxation on diaphragm ultrasound (DUS) M-mode images is known as diaphragmatic excursion (DE) ( 32 , 33 ). DE may be abnormal in cases of diaphragmatic dysfunction, such as during spinal cord injury ( 34 , 35 ), muscular dystrophy ( 34 , 36 ), and diaphragmatic paralysis ( 34 , 37 ). Pneumothorax can also cause diaphragmatic dysfunction because high pleural pressure may push the diaphragm away from its normal position.…”

Section: Introductionmentioning

confidence: 99%

Quantitative assessment of pneumothorax by using Shannon entropy of lung ultrasound M-mode image and diaphragmatic excursion based on automated measurement

Fang,

Shen,

Ting

et al. 2024

Quant Imaging Med Surg

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Background Lung ultrasound (LUS) and diaphragm ultrasound (DUS) are the appropriate modalities for conservative observation to those patients who are with stable pneumothorax, as well as for the timely detection of life-threatening pneumothorax at any location, due to they are portable, real-time, relatively cost effective, and most important, without radiation exposure. The absence of lung sliding on LUS M-mode images and the abnormality of diaphragmatic excursion (DE) on DUS M-mode images are the most common and novel diagnostic criteria for pneumothorax, respectively. However, visual inspection of M-mode images remains subjective and quantitative analysis of LUS and DUS M-mode images are required. Methods Shannon entropy of LUS M-mode image (ShanEn LM ) and DE based on the automated measurement (DE AM ) are adapted to the objective pneumothorax diagnoses and the severity quantifications in this study. Mild, moderate, and severe pneumothoraces were induced in 24 male New Zealand rabbits through insufflation of room air (5, 10 and 15, and 25 and 40 mL/kg, respectively) into their pleural cavities. In vivo intercostal LUS and subcostal DUS M-mode images were acquired using a point-of-care system for estimating ShanEn LM and DE AM . Results ShanEn LM and DE AM as functions of air insufflation volumes exhibited U-shaped curves and were exponentially decreasing, respectively. Either ShanEn LM or DE AM had areas under the receiver operating characteristic curves [95% confidence interval (CI)] of 1.0000 (95% CI: 1.0000–1.0000), 0.9833 (95% CI: 0.9214–1.0000), and 0.9407 (95% CI: 0.8511–1.0000) for differentiating between normal and mild pneumothorax, mild and moderate pneumothoraces, and moderate and severe pneumothoraces, respectively. Conclusions Our findings imply that the combination of ShanEn LM and DE AM give the promising potential for pneumothorax quantitative diagnosis.

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Respiratory failure due to diaphragm paralysis after brachial plexus injury diagnosed by point-of-care ultrasound

Cited by 5 publications

References 11 publications

The Role of Pocus in Acute Respiratory Failure: A Narrative Review on Airway and Breathing Assessment

The Role of Pocus in Acute Respiratory Failure: A Narrative Review on Airway and Breathing Assessment

Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients

Quantitative assessment of pneumothorax by using Shannon entropy of lung ultrasound M-mode image and diaphragmatic excursion based on automated measurement

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