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Diaphragmatic ultrasound

Julie Monteagudo, Catherine M Dickinson, Michelle Wakeley, Shamlal Mangray, Hale E Wills, Francois I Luks
INTRODUCTION:  Rhabdomyomatous dysplasia (RD) is a pathologic finding in CPAMs that was incorrectly attributed to their malignant potential. The increasing recognition of extrathoracic (intradiaphragmatic and intraabdominal) congenital pulmonary airway malformations (CPAMs) offers a clue to the origin of RD. We hypothesize that the presence of RD is related to the CPAM's anatomic location. MATERIALS AND METHODS:  Retrospective review was performed of all children who underwent resection of a CPAM during a 10-year period...
August 13, 2018: European Journal of Pediatric Surgery
Ankur Sharma, Sunaina Tejpal Karna, Manish Tandon, Chandra Kant Pandey, Ravindra Chaturvedi, Varuna Vyas, Akhil Dhanesh Goel
Background and Objectives: The present study was designed to explore the utility of ultrasound-guided diaphragmatic thickness in the preoperative period in healthy controls scheduled for live-related donor hepatectomy and patients suffering from chronic liver disease scheduled for liver transplantation (LT) and its use as a predictor of postoperative weaning failure. Materials and Methods: This prospective observational study was conducted in a tertiary health care center and 65 adult (18-70 years) participants (30 healthy liver donors and 35 liver transplant recipients) were enrolled for this study...
July 2018: Saudi Journal of Anaesthesia
Kazuya Mimura, Masayuki Endo, Keiko Matsuoka, Takuji Tomimatsu, Yuko Tazuke, Hiroomi Okuyama, Makoto Takeuchi, Tadashi Kimura
Congenital rachischisis and brachioesophagus with secondary intrathoracic stomach, which is described as "serpentine-like syndrome", is a very rare condition. We report the prenatal findings of serpentine-like syndrome in a fetus at 18 weeks of gestation. The stomach was entirely elevated into the thoracic area, but the liver retained its normal position. Our initial diagnosis was isolated left congenital diaphragmatic hernia (CDH). At 20 weeks of gestation, the pregnancy was terminated, and a male newborn weighing 338 g was vaginally delivered...
August 9, 2018: Journal of Medical Ultrasonics
Nens van Alfen, Jonne Doorduin, Marieke H J van Rosmalen, Jeroen J J van Eijk, Yvonne Heijdra, Andrea J Boon, Michael A Gaytant, Ries J M van den Biggelaar, Roy T M Sprooten, Peter J Wijkstra, Jan T Groothuis
OBJECTIVE: To describe the clinical phenotype and recovery of diaphragm dysfunction caused by neuralgic amyotrophy in a large cohort of patients, to improve accurate awareness of this entity, and to encourage adoption of a standardized approach for diagnosis and treatment. METHODS: This observational cohort study recruited adult patients with neuralgic amyotrophy and symptoms of idiopathic phrenic neuropathy from the database of the Dutch expert center for neuralgic amyotrophy and the Dutch centers for home mechanical ventilation...
July 27, 2018: Neurology
Gurpreet S Dhillon, Shiraz A Maskatia, Robert W Loar, John L Colquitt, Amy R Mehollin-Ray, Rodrigo Ruano, Michael A Belfort, Oluyinka O Olutoye, Joshua A Kailin
OBJECTIVES: Fetal endoscopic tracheal occlusion (FETO) is offered to fetuses with congenital diaphragmatic hernia (CDH) and severe lung hypoplasia to promote lung growth and may secondarily affect left heart growth. The effects of FETO on left heart hypoplasia (LHH) are not described post-CDH repair. METHODS: A retrospective analysis was performed for fetuses with left-sided CDH who underwent FETO and severity-matched controls from 2007-2016 at our institution. Echocardiographic, ultrasound, and MRI data were reviewed...
July 26, 2018: Prenatal Diagnosis
P Kot Baixauli, P Rodriguez Gimillo, J Baldo Gosalvez, J de Andrés Ibáñez
Phrenic nerve block is a complication that can occur after brachial plexus anaesthesia above the clavicle. The main consequence of this blockage is ipsolateral diaphragmatic paralysis, which can sometimes lead to the appearance of post-operative respiratory complications. A case is presented on a woman, who after having undergone a total shoulder prosthesis, presented with dyspnoea in the post-operative recovery unit. A diaphragmatic ultrasound was performed that enabled a rapid diagnosis to be made of a complete paralysis of the ipsolateral hemi-diaphragm...
July 19, 2018: Revista Española de Anestesiología y Reanimación
V Núñez Cerezo, M Romo Muñoz, J L Encinas, J Jiménez, M D Elorza Fernández, B Herrero, E Antolín, L Martínez Martínez, M López Santamaría
INTRODUCTION AND OBJECTIVES: The aim of this study is to identify respiratory clinic and pulmonary arterial hypertension (PAH) in congenital diaphragmatic hernia (CDH) and whether these could be predicted by prenatal measures. MATERIAL AND METHODS: We studied fetal ultrasound: Observed/expected Lung to Head Ratio (O/E LHR) and classified patients according to their outcome (group 1: O/E LHR <25%, group 2: 26-35%, group 3: 36-45%, group 4: >55%) as well as the severity of PAH (group 0: non-PAH, group 1: mild, group 2: moderate, group 3: severe) in echocardiograms at birth, 1st, 6th, 12th and 24 months of life...
April 20, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Kengo Hattori, Shigeru Takamizawa, Yuichiro Miyake, Tomoko Hatata, Katsumi Yoshizawa, Tomoko Furukawa, Yoshiaki Kondo
BACKGROUND: Sonographic assessment before congenital diaphragmatic hernia repair has rarely been studied. OBJECTIVE: To evaluate the accuracy of preoperative ultrasound in measuring the defect size and in anticipating the presence of a rim and thereby to determine ultrasound's usefulness in informing the surgical approach for definitive repair of congenital diaphragmatic hernia. MATERIALS AND METHODS: We performed a retrospective review of the medical records of seven children with left congenital diaphragmatic hernia who had undergone ultrasound and definitive repair between 2014 and 2017 at our institution...
July 5, 2018: Pediatric Radiology
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Cameron Green, Colin F Royse
BACKGROUND: Failed extubation from mechanical ventilation in critically ill patients is multifactorial, complex and not well understood. We aimed to identify whether combined transthoracic echocardiography, lung and diaphragmatic ultrasound can predict extubation failure in critically ill patients. RESULTS: Fifty-three participants who were intubated > 48 h and deemed by the treating intensivist ready for extubation underwent a 60-min pre-extubation weaning trial (pressure support ≤ 10 cmH2 O and positive end expiratory pressure 5 cmH2 O)...
July 4, 2018: Critical Ultrasound Journal
Abhinav Banerjee, Gesu Mehrotra
Background and Aims: The diaphragm is considered the main respiratory muscle and difficulty in weaning can occur because of impaired diaphragmatic function. Hence, monitoring diaphragmatic function is important. The aim of this study is to assess the ability of various lung ultrasound (US) indices and the rapid shallow breathing index (RSBI) to predict the outcome of the weaning process and compare them with RSBI. Materials and Methods: This was a prospective study conducted on patients admitted to critical care unit at a tertiary care hospital in north India from February 2017 to June 2017...
June 2018: Indian Journal of Critical Care Medicine
Søren Helbo Skaarup, Anders Løkke, Christian B Laursen
BACKGROUND: Ultrasound can be used to assess diaphragm movement. Existing methods focus on movement at a single point at the hemidiaphragm and may not consider the anatomic and functional complexity. We aimed to develop an ultrasound method, the Area method, to assess movement of the entire hemidiaphragm dome and to compare it with existing methods to evaluate accuracy, inter-rater agreement, and feasibility. METHODS: Movement of the diaphragm was evaluated by ultrasonography in 19 healthy subjects and correlated with simultaneously performed spirometry...
June 27, 2018: Critical Ultrasound Journal
Francesca Maria Russo, Anne-Gael Cordier, Luc De Catte, Julien Saada, Alexandra Benachi, Jan Deprest
Congenital diaphragmatic hernia is a rare disease associated with high mortality and morbidity. Antenatal ultrasound screening identifies more than 70% of cases, providing the opportunity for in utero referral to a tertiary care center for expert assessment and perinatal management. Additional genetic and morphologic assessment may be used to rule out associated anomalies. In isolated cases, the outcome may be predicted prenatally by medical imaging. The combination of lung size and liver herniation is a widely accepted method to stratify fetuses into groups with an increasing degree of pulmonary hypoplasia and corresponding mortality rates...
June 20, 2018: Prenatal Diagnosis
Nur Hursoy, Melahat Kul, Ayse Erden
Adrenal gland disorders can be asymptomatic and detected incidentally via imaging techniques such as ultrasound, computed tomography (CT), positron emission tomography, and magnetic resonance imaging. Fusion anomaly is a condition that can be attributed to errors in the developmental process and may be detected via these imaging modalities. We present a case of butterfly adrenal gland in a 61-year-old man with CT and magnetic resonance images. In our patient, this anomaly is also accompanied by unilateral renal agenesis and a diaphragmatic defect...
April 2018: Radiology Case Reports
Jessica Aymen, Isabelle Langlois, Isabelle Lanthier
A 10-year-old pet chinchilla (Chinchilla lanigera) was referred for ultrasound investigation of a thoracic mass. The mass was initially believed to be a pulmonary abscess or tumor based on radiographs and ultrasound. Cytological examination suggested the presence of a gastrointestinal structure in the thorax, and necropsy revealed a true diaphragmatic hernia subdividing the stomach into thoracic and abdominal portions.
May 2018: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
Sergio R Thomaz, Felipe A Teixeira, Alexandra C G B de Lima, Gerson Cipriano Júnior, Magno F Formiga, Lawrence Patrick Cahalin
BACKGROUND: Heart Failure (HF) patients usually present with increased arterial resistance and reduced blood pressure (BP) leading to an impaired functional capacity. Osteopathic Manual Therapy (OMT) focused on myofascial release techniques (MRT) and in the balancing of diaphragmatic tensions, has been shown to improve blood flow in individuals using the resistive index (RI). However, its effects in HF patients have not been examined. PURPOSE: To evaluate the acute response of selected osteopathic techniques on RI, heart rate (HR), and BP in patients with HF...
April 2018: Journal of Bodywork and Movement Therapies
Ben Ho, Michael De Paoli
BACKGROUND: Although use of the superficial cervical plexus block (SCPB) by anesthesia for perioperative indications is well described, there is a paucity of research on use of SCPB in the emergency department (ED). OBJECTIVE: This prospective observational study aims to prospectively characterize the feasibility, potential for efficacy, and safety of ultrasound-guided SCPB in a convenience sample of ED patients presenting with painful conditions of the "cape" distribution of the neck and shoulder...
July 2018: Journal of Emergency Medicine
Caifeng Li, Xin Li, Hongqiu Han, Hailong Cui, Guolin Wang, Zhiqiang Wang
BACKGROUND: Weaning failure is common in mechanically ventilated patients. Whether ultrasound can predict weaning outcome remains controversial. This meta-analysis was performed to assess the accuracy of diaphragmatic ultrasonography for predicting reintubation within 48 hours of extubation. METHODS: Literature search was performed in PubMed, Embase, and Cochrane Library to identify all the relevant papers, published in English up to July 16, 2017. Eligible studies were included if data were in adequate details to rebuild 2 × 2 contingency tables...
June 2018: Medicine (Baltimore)
Rodrigo Ruano, Denise B Klinkner, Karthik Balakrishnan, Victoria A Novoa Y Novoa, Norman Davies, Dean D Potter, William A Carey, Christopher E Colby, Amy B Kolbe, Katherine W Arendt, Leal Segura, Hans P Sviggum, Maureen A Lemens, Abimbola Famuyide, Andre Terzic
OBJECTIVE: To introduce the prenatal regenerative medicine service at Mayo Clinic for fetal endoscopic tracheal occlusion (FETO) care for severe congenital diaphragmatic hernia (CDH). PATIENTS AND METHODS: Two cases of prenatal management of severe CDH with FETO between January and August 2017 are reported. Per protocol, FETO was offered for life-threatening severe CDH at between 26 and 29 weeks' gestation. Regenerative outcome end point was fetal lung growth. Gestational age at procedure and maternal and perinatal outcomes were additional monitored parameters...
June 2018: Mayo Clinic Proceedings
Zsolt Tidrenczel, Erika P Tardy, Edina Sarkadi, Judit Simon, Artúr Beke, János Demeter
Pallister-Killian syndrome (PKS) is a rare, sporadic genetic disorder that is caused by the mosaic presence of a supernumerary marker chromosome, isochromosome 12p. The syndrome is a polydysmorphic condition characterized by mental retardation, craniofacial dysmorphism, hypotonia, seizures, epilepsy and certain organic malformations (diaphragmatic hernia, congenital heart disease). Prenatal diagnosis is challenging due to the mosaic tissue-specific distribution of the chromosomal disorder and highly variable phenotype...
May 2018: Orvosi Hetilap
Carmen Mesas Burgos, Björn Frenckner, Matias Luco, Matthew T Harting, Pamela A Lally, Kevin P Lally
AIM: To compare outcomes between prenatally and postnatally diagnosed CDH in a large multicenter database of prospectively collected data and evaluate factors associated with poorer outcome for prenatally diagnosed CDH. MATERIAL AND METHODS: We used information from the multicenter, multinational CDH Study Group database on patients born between 2007 and 2015. We compared differences between prenatally and postnatally diagnosed CDH with respect to survival, side, size, ECMO needs, associated major cardiac malformations and liver position...
April 14, 2018: Journal of Pediatric Surgery
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