Abstract:
PURPOSE:Motion-mode (MM) echography allows precise measurement of diaphragmatic excursion when the ultrasound beam is parallel to the diaphragmatic displacement. However, proper alignment is difficult to obtain in patients after cardiac surgery; thus, measurements might be inaccurate. A new imaging modality named the anatomical motion-mode (AMM) allows free placement of the cursor through the numerical image reconstruction and perfect alignment with the diaphragmatic motion. Our goal was to compare MM and AMM measurements of diaphragmatic excursion in cardiac surgical patients. METHODS:Cardiac surgical patients were studied after extubation. The excursions of the right and left hemidiaphragms were measured by two operators, an expert and a trainee, using MM and AMM successively, according to a blinded, randomized, crossover sequence. Values were averaged over three consecutive respiratory cycles. The angle between the MM and AMM cursors was quantified for each measurement. RESULTS:Fifty patients were studied. The mean (±SD) angle between the MM and AMM cursors was 37° ± 16°. The diaphragmatic excursion as measured by experts was 1.8 ± 0.7 cm using MM and 1.5 ± 0.5 cm using AMM (p < 0.001). Overall, the diaphragmatic excursion as estimated by MM was larger than the value obtained with AMM in 75 % of the measurements. Bland-Altman analysis showed tighter limits of agreement between experts and trainees with AMM [bias: 0.0 cm; 95 % confidence interval (CI): 0.8 cm] than with MM (bias: 0.0 cm; 95 % CI: 1.4 cm). CONCLUSION:MM overestimates diaphragmatic excursion in comparison to AMM in cardiac surgical patients. Using MM may lead to a lack of recognition of diaphragmatic dysfunction.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Pasero D,Koeltz A,Placido R,Fontes Lima M,Haun O,Rienzo M,Marrache D,Pirracchio R,Safran D,Cholley Bdoi
10.1007/s00134-014-3625-9subject
Has Abstractpub_date
2015-04-01 00:00:00pages
650-6issue
4eissn
0342-4642issn
1432-1238journal_volume
41pub_type
杂志文章,随机对照试验abstract:OBJECTIVES:(a) To assess whether differences in lung morphology observed in patients with adult respiratory distress syndrome (ARDS) are associated with differences in cardiorespiratory parameters, lung mechanics, and outcome. (b) To propose a new ARDS Severity Score to identify patients with a high mortality risk. DE...
journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2000-08-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
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abstract::Placement of a Swan-Ganz catheter can cause many complications. This case report presents a new complication of Swan-Ganz catheter insertion--placement of the Swan-Ganz catheter tip in the coronary sinus. ...
journal_title:Intensive care medicine
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pub_type: 杂志文章
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更新日期:2008-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章
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更新日期:1998-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:1986-01-01 00:00:00
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pub_type: 杂志文章
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-10-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2007-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,已发布勘误
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更新日期:2008-02-01 00:00:00
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更新日期:2018-03-01 00:00:00
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更新日期:2006-05-01 00:00:00
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更新日期:2004-11-01 00:00:00
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更新日期:2009-06-01 00:00:00
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pub_type: 临床试验,杂志文章
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