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Ultrasonographic modeling of lung and diaphragm mechanics: clinical trial of a novel non-invasive method to evaluate pre-operative pulmonary function. | LitMetric

Ultrasonographic modeling of lung and diaphragm mechanics: clinical trial of a novel non-invasive method to evaluate pre-operative pulmonary function.

PeerJ

Department of Intensive Care Unit, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.

Published: December 2024

AI Article Synopsis

  • The study highlights that traditional pulmonary function tests (PFTs) can be challenging due to the need for cooperation from patients, while ultrasound (US) offers a less invasive way to assess lung and diaphragm function, needing minimal cooperation.
  • Researchers conducted a prospective study with 208 patients, comparing results from PFTs to a new mathematical model that combines lung ultrasonography (LUS) and diaphragm ultrasound (DUS) to evaluate pulmonary function more effectively.
  • Key findings indicate that diaphragm thickness during deep breathing and LUS scores are significant predictors of pulmonary function, leading to the development of an ultrasonographic modeling score (U-score) that correlates well with traditional lung function metrics.

Article Abstract

Background: Pre-operative pulmonary function testing (PFT) plays a key role in predicting postoperative complications or functional impairment. However, PFT requires the subject and examiner to cooperate and the results are influenced by both technical and personal factors. In contrast, the use of ultrasound (US) for structural and functional assessments of the lungs and diaphragm is on the rise, as it requires minimal patient cooperation. Dyspnea is mainly caused by lung or pleural lesions but may also be caused by weak respiratory muscles. As the diaphragm is a primary respiratory muscle, combining lung ultrasonography (LUS) with diaphragm ultrasound (DUS) may enable a more comprehensive assessement of pulmonary function. This study aims to introduce a novel approach for assessing pulmonary function using a mathematical model based on LUS and DUS.

Methods: This prospective study was performed at the First Affiliated Hospital of Nanchang University between June 2021 and December 2021, 208 patients were recruited and underwent PFT, LUS, and DUS examinations. An experienced physician, blinded to the clinical history and PFT results, performed LUS and DUS and explored the correlations between a mathematical model (ultrasonographic modeling score (U-score)) using LUS combined with DUS and pulmonary function parameters. Univariate, multivariate, and logistic regression analyses were also performed.

Results: According to the univariate and multivariable analysis, diaphragm thickness fraction in deep breathing (D-DTF) (odds ratio (OR), 0.88; 95% confidence interval (CI) [0.83-0.94]; < 0.001), and LUS score (OR, 1.44; 95% CI [1.16-1.80]; < 0.001) were each independently associated with pulmonary function. According to the logistics equation, a U-score of -0.126 × D-DTF + 0.368 × LUS score was produced. The U-score showed a more significant negative correlation with forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) (r = -0.605, < 0.001) than the LUS or DUS indices alone. The U-score (area under the curve (AUC) = 0.971) was greater than the other indices for assessing pulmonary function.

Conclusions: With validation, the U-score through both lung and diaphragm ultrasound measurements may assist in estimating pulmonary function. This approach facilitates the assessment of pulmonary function in patients who may be unable to reliably participate in PFT.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663399PMC
http://dx.doi.org/10.7717/peerj.18677DOI Listing

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