Assessment of Diaphragmatic Mobility by Transthoracic Ultrasound in Patients with Interstitial Lung Diseases

Abstract

Background: As interstitial lung diseases may promote respiratory muscles dysfunction due to increased lung elastic recoil, chronic hypoxemia, systemic inflammation, physical inactivity, malnutrition and corticosteroids therapy. Therefore, measuring diaphragmatic function is quite helpful when assessing patients with interstitial lung disorders. Aim of the work: was to compare the diaphragmatic mobility which assessed by ultrasonography between healthy individuals and patients with interstitial lung diseases. Patients and Methods: this case-control trial, whereas Thirty patients with clinically stable interstitial lung diseases and twenty healthy persons as a control. Whereas age, sex and body mass index matched apparently in control group. Pulmonary functions tests: as six-minute walk test, ultrasonographic measurement of both diaphragmatic excursion and thicknesses at residual functional capacity and total lung capacity, with calculation of the diaphragmatic thickening fraction were done for all participants. Results: Diaphragmatic kinetics are greatly impaired in interstitial lung diseases patients at total lung capacity, but almost not affected at functional residual capacity. Diaphragmatic excursion and thickness at total lung capacity, as well as diaphragmatic thickening fraction showed considerable positive correlations with forced vital capacity and 6-minute walk distance, whereas they exhibited considerable negative correlations with modified Medical Research Council dyspnea scale. Conclusion: Diaphragmatic kinetics measured at total lung capacity and thickening fraction have good correlations with degree of dyspnea, forced vital capacity and exercise tolerance.