Objective: To study the effects that pneumoperitoneum achieved through carbon dioxide insufflation has on diaphragmatic excursion in pigs.
Methods: A total of 14 male Landrace pigs, 30 to 45 days of age and weighing five to seven kilograms each, were used. The sample was randomly and equally divided into two groups: one (n = 7) in which pneumoperitoneum was maintained at 10 mmHg for 60 minutes; and another (n = 7) in which pneumoperitoneum was maintained at 15 mmHg (also for 60 minutes). After anesthetic induction, the animals were intubated. Flow volume was monitored, and the amplitude of diaphragmatic excursion was analyzed using noninvasive ultrasound imaging of the right hemidiaphragm.
Results: In both groups, restricted diaphragmatic excursion was observed only during the procedure. There was no statistical difference between the two pressure levels studied.
Conclusion: The amplitude of diaphragmatic excursion was restricted during abdominal insufflation, independent of the pressure level (within the 10-15 mmHg range), during the study period.
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http://dx.doi.org/10.1590/s1806-37132006000100006 | DOI Listing |
J Anesth
January 2025
Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Background: This study evaluated the ability of diaphragmatic excursion (DE), measured 2 h after extubation, to predict the need for resumption of ventilatory support within 48 h in surgical critically ill patients.
Methods: This prospective observational study included adult surgical critically ill patients intubated for > 24 h and extubated after a successful spontaneous breathing trial. Sonographic measurement of the DE was performed 2 h after extubation.
Muscle Nerve
December 2024
The Higher Education Institution Fizioterapevtika, Ljubljana, Slovenia.
Introduction/aims: We aimed to determine differences in diaphragm thickness by including/excluding pleural and peritoneal membranes, the variability in diaphragm thickness over the apposition zone, and the predictors of diaphragm thickness and excursion measurements.
Methods: At least 10 male and female subjects were recruited for each decade of life. Spirometry, respiratory muscle strength, and the diaphragm ultrasound (US) measurements were performed.
Front Med (Lausanne)
December 2024
Department of Emergency, Guangxi Academy of Medical Sciences & People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Introduction: Speckle tracking ultrasound is a novel technique for evaluating diaphragm movement, yet its guidance in weaning mechanically ventilated patients remains unclear. In this study, we assessed diaphragmatic function using speckle tracking ultrasound and guided the weaning process.
Methods: A total of 86 mechanically ventilated patients were included and divided into successful or failed weaning groups.
Crit Care
December 2024
Service de Médecine Intensive - Réanimation-SRPR, APHP, Hôpital Pitié-Salpêtrière, Sorbonne Université, 75013, Paris, France.
Background: The present study was designed to investigate the evolution and the impact of respiratory muscles function and limb muscles strength on weaning success in prolonged weaning of tracheotomized patients. The primary objective was to determine whether the change in respiratory muscles function and limb muscles strength over the time is or is not associated with weaning success.
Methods: Tracheotomized patients who were ventilator dependent upon admission at a weaning center were eligible.
Intern Emerg Med
December 2024
Division of General Internal Medicine, Department of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
Diaphragmatic dysfunction is an important contributor to hypercapnic respiratory failure, but its presence is often challenging to determine at the bedside. Diaphragm ultrasound provides an opportunity to evaluate the function of the diaphragm noninvasively by evaluating the following parameters that can help define diaphragmatic dysfunction: diaphragm excursion, diaphragm muscle thickness, and thickening fraction. Its evaluation has the potential to assist with diagnosis of respiratory failure, provide prognosis, and assist with patient monitoring and should be considered as part of an internal medicine physician's and emergency physician's skill set.
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