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diaphragm ultrasound

C S Bruells, G Marx
Diaphragm function is crucial for patient outcome in the ICU setting and during the treatment period. The occurrence of an insufficiency of the respiratory pump, which is predominantly formed by the diaphragm, may result in intubation after failure of noninvasive ventilation. Especially patients suffering from chronic obstructive pulmonary disease are in danger of hypercapnic respiratory failure. Changes in biomechanical properties and fiber texture of the diaphragm are further cofactors directly leading to a need for intubation and mechanical ventilation...
October 20, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Thomas Günther Lesser, Carsten Boltze, Harald Schubert, Frank Wolfram
Background: In recent years, high intensity focused ultrasound (HIFU) has gained increasing clinical interest as a non-invasive method for local therapy of liver malignancies. HIFU treatment of tumours and metastases in the liver dome is limited due to the adjacent ultrasound blocking lung. One-lung flooding (OLF) enables complete sonography of lung and adjoining organs including liver. HIFU liver ablation passing through the flooded lung could enable a direct intercostal beam path and thus improve dose deposition in liver...
2016: International Journal of Medical Sciences
Carolin A Boecking, Eleanor A Drey, Jennifer L Kerns, Walter E Finkbeiner
CONTEXT: -Despite increased use of dilation and evacuation in the setting of fetuses with developmental anomalies, the pathology examination of fragmented specimens obtained by this technique has been understudied. OBJECTIVES: -To correlate pathologic findings in second-trimester fetal dilation and evacuation specimens with prenatal diagnoses established through ultrasound and/or chromosome studies to determine the value of pathology examination for supplementing or correcting clinical diagnoses...
October 20, 2016: Archives of Pathology & Laboratory Medicine
Kanika Gupta, Bhuvaneswari Venkatesan, Kiruba Shankar Manoharan, Vaithianathan Rajalakshmi, Maya Menon
Congenital high airway obstruction syndrome is a rare fetal anomaly with characteristic constellation of prenatal findings on ultrasound and MRI. The typical triad of imaging features are enlarged and echogenic lungs, flattening or inversion of diaphragm and fetal hydrops. Early prenatal recognition of congenital high airway obstruction syndrome by ultrasound and/or MRI is mandatory for the appropriate perinatal management. We report a case of a male fetus with typical imaging findings of congenital high airway obstruction syndrome on ultrasound and MRI at 19 weeks of gestation...
August 2016: Journal of Radiology Case Reports
Susana Pinto, Pedro Alves, Michael Swash, Mamede de Carvalho
AIMS OF THE STUDY: To compare the assessment of respiratory decline with conventional tests, measurement of diaphragm compound muscle action potential (CMAP) to phrenic nerve stimulation and diaphragm thickness to ultrasound (US) investigation in amyotrophic lateral sclerosis (ALS) patients followed for a short period of time. PATIENTS AND METHODS: We evaluated in 40 consecutive ALS patients, the clinical functional scale (ALSFRS-R), forced vital capacity (FVC), maximal voluntary ventilation (MVV), maximal inspiratory (MIP) and expiratory (MEP) pressures, sniff nasal inspiratory pressure (SNIP), Diaphragm-CMAP (latency and amplitude) and diaphragm US (maximal and minimal diaphragm thickness during full inspiration and expiration, respectively)...
October 14, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
Anthony Blaeser, Hiroyuki Awano, Bo Wu, Qi-Long Lu
Mutations in the gene for fukutin-related protein represent a subset of muscular dystrophies known as dystroglycanopathies characterized by loss of functionally-glycosylated-alpha-dystroglycan and a wide range of dystrophic phenotypes. Mice generated by our lab containing the P448L mutation in the fukutin-related protein gene demonstrate the dystrophic phenotype similar to that of LGMD2I. Here we examined the morphology of the heart and diaphragm, focusing on pathology of diaphragm and cardiac function of the mutant mice for up to 12 months...
2016: PloS One
Cullen M O'Gorman, Travis G O'Brien, Andrea J Boon
INTRODUCTION: Ultrasound (US) evaluation of diaphragm thickness and contractility is an effective tool in neurogenic diaphragm dysfunction. There are limited data about the value of this technique in patients with myopathy. METHODS: We performed a retrospective chart review of cases with EMG-confirmed myopathy and real-time US evaluation of the diaphragm. Diaphragm thickness and thickening ratio (maximal inspiration/expiration) were measured. Demographic, imaging, pathology, and genetic data were reviewed, and the clinical diagnosis was recorded...
October 4, 2016: Muscle & Nerve
Zhihua Lu, Qiuping Xu, Yuehua Yuan, Ge Zhang, Feng Guo, Huiqing Ge
BACKGROUND: Diaphragmatic dysfunction is often underdiagnosed and is among the risk factors for failed weaning. The purpose of this study was to determine the prevalence of diaphragmatic dysfunction diagnosed by B-mode ultrasonography and to determine whether prolonged weaning subjects with diaphragmatic dysfunction have increased duration of mechanical ventilation compared with those without diaphragmatic dysfunction. METHODS: This was a prospective observational study in mechanically ventilated subjects who failed ≥3 spontaneous breathing trials or required >7 d of weaning after the first spontaneous breathing trial...
October 2016: Respiratory Care
Benjamin J Bonte, Jason Freeman, Gary Fang, Harald Sauthoff
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Margarita G Todorova, Cameron F Parsa
BACKGROUND: Variable pupillary responses have been described with carotid-cavernous sinus fistulas. These often are associated with a decrease in visual acuity and attributed to retinal ischemia. We propose a novel pathophysiologic mechanism for changes in pupillary reactivity involving anatomic changes secondary to choroidal effusion. METHODS: To demonstrate proof-of-concept, we investigated 2 consecutive patients with carotid-cavernous sinus fistulas and pupillary disturbances using repeated refractions and anterior segment ultrasound biomicroscopy...
September 22, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Laura Mary, Sophie Scheidecker, Monique Kohler, Maria-Paola Lombardi, Anne-Lise Delezoide, Elisabeth Auberger, Stéphane Triau, Estelle Colin, Marion Gerard, Karl-Heinz Grzeschik, Hélène Dollfus, Maria Cristina Antal
Focal dermal hypoplasia (FDH) is a rare syndrome characterized by pleiotropic features knowing to involve mostly skin and limbs. Although FDH has been described in children and adults, the cardinal signs of the fetal phenotype are not straightforward impacting the quality of the prenatal diagnosis. We describe in depth the ultrasound, radiological, macroscopical, and histological phenotype of three female fetuses with a severe form of FDH, propose a review of the literature and an attempt to delineate minimal and cardinal signs for FDH diagnosis...
September 13, 2016: American Journal of Medical Genetics. Part A
Massimo Zambon, Massimiliano Greco, Speranza Bocchino, Luca Cabrini, Paolo Federico Beccaria, Alberto Zangrillo
PURPOSE: Diaphragmatic dysfunction (DD) has a high incidence in critically ill patients and is an under-recognized cause of respiratory failure and prolonged weaning from mechanical ventilation. Among different methods to assess diaphragmatic function, diaphragm ultrasonography (DU) is noninvasive, rapid, and easy to perform at the bedside. We systematically reviewed the current literature assessing the usefulness and accuracy of DU in intensive care unit (ICU) patients. METHODS: Pubmed, Cochrane Database of Systematic Reviews, Embase, Scopus, and Google Scholar Databases were searched for pertinent studies...
September 12, 2016: Intensive Care Medicine
Chia-Chun Kuo, Ho-Chiao Chuang, Kuan-Ting Teng, Hsiao-Yu Hsu, Der-Chi Tien, Chih-Jen Wu, Shiu-Chen Jeng, Jeng-Fong Chiou
The purpose of this study was to develop an ultrasound image tracking algorithm (UITA) for extracting the exact displacement of internal organs caused by respiratory motion. The program can track organ displacements in real time, and analyze the displacement signals associated with organ displacements via a respiration compensating system (RCS). The ultrasound imaging system is noninvasive and has a high spatial resolution and a high frame rate (around 32 frames/s), which reduces the radiation doses that patients receive during computed tomography and X-ray observations...
September 9, 2016: Journal of X-ray Science and Technology
Irene Dot, Purificación Pérez-Teran, Manuel-Andrés Samper, Joan-Ramon Masclans
Muscle involvement is found in most critical patients admitted to the intensive care unit (ICU). Diaphragmatic muscle alteration, initially included in this category, has been differentiated in recent years, and a specific type of muscular dysfunction has been shown to occur in patients undergoing mechanical ventilation. We found this muscle dysfunction to appear in this subgroup of patients shortly after the start of mechanical ventilation, observing it to be mainly associated with certain control modes, and also with sepsis and/or multi-organ failure...
August 20, 2016: Archivos de Bronconeumología
Stephen A Goutman, James D Hamilton, Blake Swihart, Bradley Foerster, Eva L Feldman, Jonathan M Rubin
INTRODUCTION: Diaphragm excursion measured via ultrasound may be an important imaging outcome measure of respiratory function. We developed a new method of measuring diaphragm movement and compared this to the more traditional M-mode method. METHODS: Ultrasound images of the right and left hemidiaphragms were collected to compare speckle tracking and M-mode measurements of diaphragm excursion. Speckle tracking was performed in EchoInsight (Epsilon Imaging, Ann Arbor, MI)...
August 17, 2016: Muscle & Nerve
Younes Moutakiallah, Ilham Maaroufi, Mahdi Aithoussa, Mehdi Bamous, Abdessamad Abdou, Noureddine Atmani, Abdedaïm Hatim, Brahim Amahzoune, Youssef El Bekkali, Abdelatif Boulahya
Subaortic diaphragm is characterized by a certain clinical latency and low morbi-mortality. Surgery remains the treatment of choice despite the real risk of long-term recurrence. Our study involved 18 patients with subaortic diaphragm operated between April 1994 and March 2011. The average age was 18.1 ± 9.7 years, 11 patients were male. The diaphragm was fibrous in 13 patients and fibromuscular in 5 patients. All patients underwent diaphragm resection associated with myectomy, aortic plasty, closure of ventricular septal defect and permeable ductus arteriosus ligation in 3, 3, 2 and 2 patients respectively...
2016: Pan African Medical Journal
Steven C Reynolds, Ramasamy Meyyappan, Viral Thakkar, Bao D Tran, Marc-André Nolette, Gautam Sadarangani, Rodrigo A Sandoval, Laura Bruulsema, Brett Hannigan, Jason W Li, Elizabeth Rohrs, Jason Zurba, Joaquín Andrés Hoffer
Rationale Ventilator-induced Diaphragm Dysfunction is a significant contributor to weaning difficulty in ventilated critically ill patients. It has been hypothesized that electrically pacing the diaphragm during mechanical ventilation could reduce diaphragm dysfunction. Objectives We tested a novel, central line catheter-based, transvenous phrenic nerve pacing therapy for protecting the diaphragm in sedated and ventilated pigs. Methods Eighteen Yorkshire pigs were studied. Six pigs were sedated and mechanically ventilated for 2...
August 8, 2016: American Journal of Respiratory and Critical Care Medicine
Margaret J Lin, Kiersten Gurley, Beatrice Hoffmann
OBJECTIVES: Improper placement of the tracheal tube during intubation can lead to dangerous complications, and bedside ultrasound has been proposed as a method of quickly and accurately identifying tube placement. Recent studies in adults have found it to be accurate, but its applicability in pediatric patients is unclear. This systematic review aims to describe the current available data on the accuracy and feasibility of bedside ultrasound for tracheal tube placement in children. DATA SOURCES: OVID MEDLINE and EMBASE...
October 2016: Pediatric Critical Care Medicine
Johanna M M van Breugel, Joost W Wijlemans, Hermanus H B Vaessen, Martijn de Greef, Chrit T W Moonen, Maurice A A J van den Bosch, Mario G Ries
BACKGROUND: Previous studies demonstrated both pre-clinically and clinically the feasibility of magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablations in the liver. To overcome the associated problem of respiratory motion of the ablation area, general anesthesia (GA) and mechanical ventilation was used in conjunction with either respiratory-gated energy delivery or energy delivery during induced apnea. However, clinical procedures requiring GA are generally associated with increased mortality, morbidity, and complication rate compared to procedural sedation and analgesia (PSA)...
2016: Journal of Therapeutic Ultrasound
Sam R Orde, Andrea J Boon, Daniel G Firth, Hector R Villarraga, Hiroshi Sekiguchi
BACKGROUND: Conventionally, ultrasonographic assessment of diaphragm contractility has involved measuring respiratory changes in diaphragm thickness (thickening fraction) using B-mode or caudal displacement with M-mode. Two-dimensional speckle-tracking has been increasingly used to assess muscle deformation ('strain') in echocardiography. We sought to determine in a pilot study if this technology could be utilized to analyze diaphragmatic contraction. METHODS: Fifty healthy adult volunteers with normal exercise capacity underwent ultrasound imaging...
2016: BMC Anesthesiology
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