|
|
| Title |
ULTRASOUND EVALUATION OF DIAPHRAGM FUNCTION IN
CHILDREN WITH CHRONIC RESPIRATORY FAILURE. |
| Author |
Kocis KC*, Shaikh YS*, Kuroda CA*, Sternberger
WI, Nichols DG |
| Affiliation |
University of Southern California*, Departments
of Pediatrics and Surgery, Childrens Hospital Los Angeles, Los Angeles, CA 90027 |
| Introduction |
Clinically, a noninvasive measure of diaphragm
function is needed in children. We hypothesized that ultrasonography can quantify
diaphragm function and identify those children with chronic respiratory failure. |
| Method |
15 children were studied prospectively with mean
age=2.1±6.3 yrs (range=0-22 yrs). The following groups were studied: 1)children after
cardiac surgery and immediately before successful extubation (normal); 2)children with
chronic respiratory failure (chronic). Ultrasound measurements were made during breathing
through a T piece before and after adding 5% carbon dioxide (CO2).
The inspiratory (i) and expiratory (e) effort dependent measurements indexed for body
surface area were: A)mean velocity (VELi(cm/sec/m2)) of the posterior diaphragm
in transverse section, B)distance of the posterior diaphragm from the most anterior
adrenal gland/kidney junction (Di, De (cm/m2)) and inspiratory time (TI (sec/m2))
in sagittal section. The difference between Di and De (delta D(cm/m2)) was
calculated. Measurements were made in triplicate and averaged. Data were analyzed using
independent Student’s t test with p<0.05 being significant. |
| Result |
(mean±sem)
(*=difference from Normal, p< 0.05)
| |
n |
VELI |
D
D |
Ti |
| Normal |
10 |
8.5±1.6 |
1.9±0.4 |
1.7±0.2 |
| Chronic |
5 |
2.7±0.9* |
0.8±0.2* |
0.8±0.2* |
| Normal+CO2 |
9 |
8.9±1.4 |
2.2±0.5 |
1.9±0.2 |
| Chronic+CO2 |
4 |
4.6±2.4 |
0.5±0.2* |
1.0±0.2* |
|
| Conclusion |
Ultrasonography can be used to quantify
diaphragm function and discriminate between normal children and those with chronic
respiratory failure. |
|
|