Abstract
ObjectivesBedside ultrasound techniques have the unique ability to produce instantaneous, dynamic images, and have demonstrated widespread utility in both emergency and critical care settings. The aim of this article is to introduce a novel application of this imaging modality by utilizing an ultrasound based mathematical model to assess respiratory function. With validation, the proposed models have the potential to predict pulmonary function in patients who cannot adequately participate in standard spirometric techniques (inability to form tight seal with mouthpiece, etc.).MethodsUltrasound was used to measure diaphragm thickness (Tdi) in a small population of healthy, adult males at various points of the respiratory cycle. Each measurement corresponded to a generated negative inspiratory force (NIF), determined by a handheld meter. The data was analyzed using mixed models to produce two representative mathematical models.ResultsTwo mathematical models represented the relationship between Tdi and NIFmax, or maximum inspiratory pressure (MIP), both of which were statistically significant with p-values <0.005: 1. log(NIF) = -1.32+4.02×log(Tdi); and 2. NIF = -8.19+(2.55 × Tdi)+(1.79×(Tdi2)).ConclusionsWith validation, these models intend to provide a method of estimating MIP, by way of diaphragm ultrasound measurements, thereby allowing evaluation of respiratory function in patients who may be unable to reliably participate in standard spirometric tests.
Highlights
Evaluation of respiratory function is a vital component in the assessment of patients with a wide range of clinical derangements
Two mathematical models represented the relationship between Tdi and NIFmax, or maximum inspiratory pressure (MIP), both of which were statistically significant with p-values
negative inspiratory force (NIF) = -8.19+(2.55 × Tdi)+(1.79×(Tdi2)). These models intend to provide a method of estimating MIP, by way of diaphragm ultrasound measurements, thereby allowing evaluation of respiratory function in patients who may be unable to reliably participate in standard spirometric tests
Summary
Evaluation of respiratory function is a vital component in the assessment of patients with a wide range of clinical derangements. Spirometric techniques, such as negative inspiratory force (NIF) and vital capacity (VC), are commonly used for such assessments. These techniques, are limited by patients’ ability to form a tight seal with their lips around a measurement device, or to coordinate precise instructions from a respiratory technician [1]. Alternative assessment via ultrasound (US) imaging of the diaphragm presents a possible method for alleviating such limitations. US measurements recorded at the diaphragm’s Zone of Apposition (ZOA) have shown to correlate with the muscle’s strength and shortening [7], and have been further proven to reliably assess global diaphragm function [6, 8,9,10]
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