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Subject Area

Obstetrics and Gynecology

Article Type

Original Study

Abstract

Objective Ultasonographic assessment of the diaphragm in patients with chronic obstructive pulmonary disease (COPD) and studying its correlation with spiromertric parameters. Background COPD represents a model of respiratory muscle dysfunction. The diaphragm is the main respiratory muscle, and its assessment is mandatory in the evaluation of patients with COPD. Ultrasonography can be used to assess diaphragmatic thickness, thickening, and excursion. Patients and methods This study included 40 patients with COPD and 10 healthy controls. All participants underwent detailed history taking, clinical examination, chest radiographies, 6-min walk test, spirometry [measurement of forced expiratory volume in one second/forced vital capacity (FEV1/FVC), FVC, FEV1, and maximum voluntary ventilation percentage of predicted], and ultrasonographic examination to measure diaphragmatic thickness (TD) at different lung volumes and capacities, thickening, and excursion. Results A highly statistically significant difference (P < 0.001) between patients with COPD and controls regarding FEV1/FVC, FEV1, and maximum voluntary ventilation percentage of predicted and a statistically significant difference (P = 0.04) between both groups regarding FVC% of predicted were found. There was a highly statistically significant difference (P < 0.001) among patients with COPD with different grades of severity regarding diaphragmatic thicknesses (TDRV, TDFRC, and TDTLC), diaphragmatic thickening (TDTLCFRC), and diaphragmatic excursion. There was a statistically significant difference (P = 0.002) among different COPD grades regarding diaphragmatic thickening (TDTLCRV). Measurements of diaphragmatic thicknesses (TDFRC and TDTLC) and thickenings (TDTLCRV and TDTLCFRC) decrease significantly in female patients more than in male patients (P = 0.049, 0.031, 0.005, and 0.044, respectively). Conclusion Diaphragmatic thickness, thickening, and excursion decrease in patients with COPD and in female more than in male patients. These ultrasonographic measurements negatively correlate with the severity of the disease.

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