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Diaphragmatic assessment in COPD patients by different modalities

Background: The study of diaphragm is considered a key point in the evaluation of COPD patients. Ultrasonography can be used for assessment of the site, structure and the motion of the diaphragm, assessment of excursion and thickness and diagnosis of paralyzed diaphragm. Subjects and methods: We conducted our work on 50 subjects, 40 COPD cases and 10 age and gender matched healthy control persons. They exposed to thorough history assessment, general and local chest examination, spirometric measurements (pre-and post-bronchodilators) including FEV1, FVC, FEV1/FVC, MVV, MIP and MEP then chest ultrasonography at different lung volumes was done. Results: MIP and MEP are decreased in COPD patients than control and with increasing grade of severity of the disease. Also, diaphragmatic thickness at different lung volumes (TDRV, TDFRC and TDTLC), diaphragmatic thickenings and excursion all are decreased in COPD than control. Highly significant positive correlation was found between diaphragmatic thickness at different lung volumes (TDRV, TDFRC and TDTLC), diaphragmatic thickenings and excursion with the spirometric finding as FEV1, MIP and MEP. Conclusion: US, MIP and MEP are non-invasive accurate methods in assessment of diaphragmatic function.