Возможности ультразвукового исследования диафрагмы - Журнал Терапевтический архив №3 Вопросы пульмонологии 2019
Возможности ультразвукового исследования диафрагмы
Для цитирования: Неклюдова Г.В., Авдеев С.Н. Возможности ультразвукового исследования диафрагмы. Терапевтический архив. 2019; 91 (3): #–92. DOI: 10.26442/00403660.2019.03.000129
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Аннотация
Ультразвуковой метод является неинвазивным и безопасным методом диагностики. Ультразвуковое исследование (УЗИ) диафрагмы позволяет провести прямое исследование ее структуры и функции. Используя стационарные и портативные УЗ-сканеры, исследование диафрагмы может быть осуществлено в специализированных лабораториях, в амбулаторных отделениях, в различных отделениях клиники, в том числе и в отделениях интенсивной терапии, у больных, находившихся в разных клинических состояниях. УЗИ диафрагмы может быть реализовано на приборах разных технических уровней. Несмотря на то, что в настоящее время метод УЗИ диафрагмы не стандартизован, тем не менее, он позволяет получить клинически важную информацию для решения различных клинических исследований, в том числе и при проведении динамического наблюдения.
Ключевые слова: диафрагма, ультразвуковое исследование, болезни органов дыхания.
Keywords: diaphragm, ultrasonography, respiratory diseases.
Ключевые слова: диафрагма, ультразвуковое исследование, болезни органов дыхания.
________________________________________________
Keywords: diaphragm, ultrasonography, respiratory diseases.
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2. Laghi F, Tobin MJ. Disorders of the respiratory muscles. Am J Respir Crit Care Med. 2003;168:10-48. doi:10.1164/rccm.2206020
3. Papa GFS, Pellegrino GM, Di Marco F, Imeri G, Brochard L, Goligher E, et al. A Review of the Ultrasound Assessment of Diaphragmatic Function in Clinical Practice. Respiration. 2016;91:403-11. doi: 10.1159/000446518
4. Perley VE, Gichkin AYu, Kameneva MYu, Aleksandrov AL. Functional condition of the diaphragm in patients with chronic obstructive pulmonary disease. Vestn Tversk gos un-ta. 2013;29:211-9 (In Russ.). ISSN 1995-0160
5. Isaev GG. The physiology of the respiratory muscles. In: Breslav I.S., Isaev G.G. (Eds.). The physiology of respiration. Saint Petersburg: Nauka, 1994:178-97 (In Russ.)
6. Chuchalin AG, Pokrovskiĭ VM. Breath. In: Pokrovskiĭ V.M., Korotʹko G.F. (Eds.) Human physiology. Moscow: Meditsina, 2003:347-85 (In Russ.)
7. West J. The physiology of respiration. The basics. Moscow: Mir, 1988 (In Russ.)
8. Toledo NSG, Kodaira SK, Massarollo PCB, Osvaldo IP, Mies S. Right hemidiaphragmatic mobility: assessment with US measurement of craniocaudal displacement of left branches of portal vein. Radiology. 2003;228:389-94. PMID: 12819344. doi: 10.1148/radiol.2282011554
9. Testa A, Soldati G, Giannuzzi R, Berardi S, Portale G, Silveri NG. Ultrasound M-mode assessment of diaphragmatic kinetics by anterior transverse scanning in healthy subjects. Ultrasound Med Biol. 2011;37:44-52. doi: 10.1016/j.ultrasmedbio.2010.10.004
10. Ye X, Xiao H, Bai W, Liang Y, Chen M, Zhang S. Two-dimensional strain ultrasound speckle tracking as a novel approach for the evaluation of right hemidiaphragmatic longitudinal deformation. Exp Ther Med. 2013;6:368-72. doi: 10.3892/etm.2013.1133
11. Orde SR, Boon AJ, Firth DG, Villarraga HR, Sekiguchi H. Diaphragm assessment by two dimensional speckle tracking imaging in normal subjects. BMC Anesthesiol. 2016;16:43. doi: 10.1186/s12871-016-0201-6
12. Goutman SA, Hamilton JD, Swihart B, Foerster B, Feldman EL, Rubin JM. Speckle tracking as a method to measure hemidiaphargm excursion. Muscle Nerve. 2017;55:125-7. doi: 10.1002/mus.25380
13. Ferrari G, Skaarup SH, Panero F, Wrightson JM. The diaphragm. In: Laursen CB, Rahman NM, Volpicelli G, eds. Thoracic Ultrasound (ERS Monograph). Sheffield, European Respiratory Society, 2018:129-147. doi: 10.1183/2312508X.10006917
14. Vivier E, Dessap AM, Dimassi S, Vargas F, Lyazidi A, Thille AW. Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation. Intensive Care Med. 2012;38:796-803. doi: 10.1007/s00134-012-2547-7
15. Marchioni A, Castaniere I, Tonelli R, Fantini R, Fontana M, Tabbì L, et al. Ultrasound-assessed diaphragmatic impairment is a predictor of outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease undergoing noninvasive ventilation. Critical Care. 2018;22:109. doi: 10.1186/s13054-018-2033-x
16. DiNino E, Gartman EJ, Sethi JM, McCool FD. Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation. Thorax. 2014;69:423-7. doi: 10.1136/thoraxjnl-2013-204111
17. Boon AJ, Harper CJ, Ghahfarokhi LS, Strommen JA., Watson JC, Sorenson EJ. Two-dimensional ultrasound imaging of the diaphragm: quantitative values in normal subjects. Muscle Nerve. 2013;47:884-9. doi: 10.1002/mus.23702
18. Harper CJ, Shahgholi L, Cieslak K, Hellyer NJ, Strommen JA, Boon AJ. Variability in diaphragm motion during normal breathing, assessed with B-mode ultrasound. J Orthop Sport Phys Ther. 2013;43:927-31. doi: 10.2519/jospt.2013.4931
19. Ayoub J, Cohendy R, Dauzat M, Targhetta R, De la Coussaye JE, Bourgeois JM, et al. Non-invasive quantification of diaphragm kinetics using M-mode sonography. Can J Anaesth. 1997;44:739-44.
20. Cohen E, Mier A, Heywood P, Murphy K, Boultbee J, Guz A. Excursion–volume relation of the right hemidiaphragm measured by ultrasonography and respiratory airflow measurements. Thorax. 1994;49:885-9. PMID: 7940428
21. Harris RS, Giovannetti M, Kim BK. Normal ventilatory movement of the right hemidiaphragm studied by ultrasonography and pneumotachography. Radiology. 1983;146:141-4. doi: 10.1148/radiology.14 6.1.6849035
22. Houston JG, Angus RM, Cowan MD, McMillan NC, Thomson NC. Ultrasound assessment of normal hemidiaphragmatic movement: relation to inspiratory volume. Thorax. 1994;49:500-3. doi: 10.1136/thx.49.5.500
23. Boussuges A, Gole Y, Blanc P. Diaphragmatic motion studied by M-mode ultrasonography: methods, reproducibility, and normal values. Chest. 2009;135:391-400. doi: 10.1378/chest.08-1541
24. Fedullo A, Lerner RM, Gibson J, Shayne DS. Sonographic measurement of diaphragmatic motion after coronary artery bypass surgery. Chest. 1992;102:1683-6. doi: 10.1378/chest.102.6.1683
25. Cohn D, Benditt JO, Eveloff S, McCool FD. Diaphragm thickening during inspiration. J Appl Physiol. 1997;83:291-6. doi: 10.1152/jappl.1997.8 3.1.291
26. Carrillo-Esper R, Perez-Calatayud AA, Arch-Tirado E, Díaz-Carrillo MA, Garrido-Aguirre E, Tapia-Velazco R, et al. Standardization of sonographic diaphragm thickness evaluations in healthy volunteers. Respir Care. 2016;61:920-4. doi: 10.4187/respcare.03999
27. Ueki J, De Bruin PF, Pride NB. In vivo assessment of diaphragm contraction by ultrasound in normal subjects. Thorax. 1995;50:1157-61. PMID: 8553271
28. Jubran A. Critical illness and mechanical ventilation: effects on the diaphragm. Respir Care. 2006;51:1054-61. PMID:16934168
29. Grosu HB, Lee YI, Lee J, Eden E, Eikermann M, Rose KM. Diaphragm muscle thinning in patients who are mechanically ventilated. Chest. 2012;142:1455-60. doi: 10.1378/chest.11-1638
30. Levine S, Nguyen T, Taylor N, Friscia ME, Budak MT, Rothenberg P, et al. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Engl J Med. 2008;358:1327-35. doi: 10.1056/NEJMoa070447
31. Shanely RA, Zergeroglu MA, Lennon SL, Sugiura T, Yimlamai T, Enns D, et al. Mechanical ventilation-induced diaphragmatic atrophy is associated with oxidative injury and increased proteolytic activity. Am J Respir Crit Care Med. 2002;166:1369-74. doi: 10.1164/rccm.200202-088 OC
32. Sassoon CS, Caiozzo VJ, Manka A, Sieck GC. Altered diaphragm contractile properties with controlled mechanical ventilation. J Appl Physiol. 2002 Jun;92(6):2585-95. doi: 10.1152/japplphysiol.01213.2001
33. Goligher EC, Fan E, Herridge MS, Murray A, Vorona S, Brace D, et al. Evolution of diaphragm thickness during mechanical ventilation: impact of inspiratory effort. Am J Respir Crit Care Med. 2015;192:1080-8. doi: 10. 1164/rccm.201503-0620OC
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35. Kim WY, Suh HJ, Hong SB, Koh Y, Lim Ch-M. Diaphragm dysfunction assessed by ultrasonography: influence on weaning from mechanical ventilation. Crit Care Med. 2011;39:2627-30. doi: 10.1097/ CCM.0b013e3182266408
36. Jiang J, Tsai T, Jerng J. Ultrasonographic evaluation of liver/spleen movements and extubation outcome. Chest. 2004;126:179-85. PMID: 1524 9460
37. Farghaly S, Hasan AA. Diaphragm ultrasound as a new method to predict extubation outcome in mechanically ventilated patients. Aust Crit Care. 2017;30:37-43. doi: 10.1016/j.aucc.2016.03.004
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39. Ferrari G, De Filippi G, Elia F, Panero F, Volpicelli G, Aprà F. Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation. Crit Ultrasound J. 2014;6:8. doi: 10.1186/2036-7902-6-8
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42. Mier A, Brophy C, Moxham J, Green M. Twitch pressures in the assessment of diaphragm weakness. Thorax. 1989;44:990-6. PMID: 2617452
43. Verin E, Delafosse C, Straus C, Morélot-Panzini C, Avdeev S, Derenne JP, et al. Effects of muscle group recruitment on sniff transdiaphragmatic pressure and its components. Eur J Appl Physiol. 2001;85:593-8. doi: 10.1007/s0042101004
44. Doorduin J, van Hees HW, van der Hoeven JG, Heunks LM. Monitoring of the respiratory muscles in the critically ill. Am J Respir Crit Care Med. 2013;187:20-7. Nlm PMID: 23103733
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50. Arora NS, Rochester DF. COPD and human diaphragm muscle dimensions. Chest. 1987;91:719-24. PMID: 3568775
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27. Ueki J, De Bruin PF, Pride NB. In vivo assessment of diaphragm contraction by ultrasound in normal subjects. Thorax. 1995;50:1157-61. PMID: 8553271
28. Jubran A. Critical illness and mechanical ventilation: effects on the diaphragm. Respir Care. 2006;51:1054-61. PMID:16934168
29. Grosu HB, Lee YI, Lee J, Eden E, Eikermann M, Rose KM. Diaphragm muscle thinning in patients who are mechanically ventilated. Chest. 2012;142:1455-60. doi: 10.1378/chest.11-1638
30. Levine S, Nguyen T, Taylor N, Friscia ME, Budak MT, Rothenberg P, et al. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Engl J Med. 2008;358:1327-35. doi: 10.1056/NEJMoa070447
31. Shanely RA, Zergeroglu MA, Lennon SL, Sugiura T, Yimlamai T, Enns D, et al. Mechanical ventilation-induced diaphragmatic atrophy is associated with oxidative injury and increased proteolytic activity. Am J Respir Crit Care Med. 2002;166:1369-74. doi: 10.1164/rccm.200202-088 OC
32. Sassoon CS, Caiozzo VJ, Manka A, Sieck GC. Altered diaphragm contractile properties with controlled mechanical ventilation. J Appl Physiol. 2002 Jun;92(6):2585-95. doi: 10.1152/japplphysiol.01213.2001
33. Goligher EC, Fan E, Herridge MS, Murray A, Vorona S, Brace D, et al. Evolution of diaphragm thickness during mechanical ventilation: impact of inspiratory effort. Am J Respir Crit Care Med. 2015;192:1080-8. doi: 10. 1164/rccm.201503-0620OC
34. Schepens S, Verbrugghe W, Dams K, Corthouts B, Parizel PM, Jorens PG. The course of diaphragm atrophy in ventilated patients assessed with ultrasound: a longitudinal cohort study. Crit Care. 2015;19:422-8. doi: 10. 1186/s13054-015-1141-0
35. Kim WY, Suh HJ, Hong SB, Koh Y, Lim Ch-M. Diaphragm dysfunction assessed by ultrasonography: influence on weaning from mechanical ventilation. Crit Care Med. 2011;39:2627-30. doi: 10.1097/ CCM.0b013e3182266408
36. Jiang J, Tsai T, Jerng J. Ultrasonographic evaluation of liver/spleen movements and extubation outcome. Chest. 2004;126:179-85. PMID: 1524 9460
37. Farghaly S, Hasan AA. Diaphragm ultrasound as a new method to predict extubation outcome in mechanically ventilated patients. Aust Crit Care. 2017;30:37-43. doi: 10.1016/j.aucc.2016.03.004
38. Umbrello M, Formenti P, Longhi D, Galimberti A, Piva I, Pezzi A, et al. Diaphragm ultrasound as indicator of respiratory effort in critically ill patients undergoing assisted mechanical ventilation: a pilot clinical study. Critical Care. 2015;19:161. doi: 10.1186/s13054-015-0894-9
39. Ferrari G, De Filippi G, Elia F, Panero F, Volpicelli G, Aprà F. Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation. Crit Ultrasound J. 2014;6:8. doi: 10.1186/2036-7902-6-8
40. Davison A, Mulvey D. Idiopathic diaphragmatic weakness. BMJ. 1992;304:492-4. PMID: 1547426
41. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166:518-624. doi: 10.1164/rccm.166.4.518
42. Mier A, Brophy C, Moxham J, Green M. Twitch pressures in the assessment of diaphragm weakness. Thorax. 1989;44:990-6. PMID: 2617452
43. Verin E, Delafosse C, Straus C, Morélot-Panzini C, Avdeev S, Derenne JP, et al. Effects of muscle group recruitment on sniff transdiaphragmatic pressure and its components. Eur J Appl Physiol. 2001;85:593-8. doi: 10.1007/s0042101004
44. Doorduin J, van Hees HW, van der Hoeven JG, Heunks LM. Monitoring of the respiratory muscles in the critically ill. Am J Respir Crit Care Med. 2013;187:20-7. Nlm PMID: 23103733
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47. Lerolle N, Guerot E, Dimassi S, Zegdi R, Faisy Ch, Fagon J-Y, et al. Ultrasonographic diagnostic criterion for severe diaphragmatic dysfunction after cardiac surgery. Chest. 2009;135:401-7. doi: 10.1378/chest.08-1531
48. Gottesman E, McCool FD. Ultrasound evaluation of the paralyzed diaphragm. Am J Respir Crit Care Med. 1997;155:1570-4. doi: 10.1164/ ajrccm.155.5.9154859
49. Anderson L, Benditt JO, Conomos P, Hoppin FG, McCool FD, Sherman CB. Variability of diaphragm structure among healthy individuals. Am J Respir Crit Care Med. 1997;155:1323-8. PMID: 9105074
50. Arora NS, Rochester DF. COPD and human diaphragm muscle dimensions. Chest. 1987;91:719-24. PMID: 3568775
51. Boon AJ, Sekiguchi H, Harper CJ, Strommen JA, Ghahfarokhi LS, Watson JC, et al. Sensitivity and specificity of diagnostic ultrasound in the diagnosis of phrenic neuropathy. Neurology. 2014;83:1264-70. doi: 10.1212/WNL.0000000000000841
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54. Горбунков С.Д., Варламов В.В., Гичкин А.Ю., Перлей В.Е., Черный С.М., Романихин А.И. и др. Ультразвуковая оценка состояния диафрагмы у больных, прошедших отбор для хирургической редукции объема легких. Вестник хирургии имени И.И. Грекова. 2015;174(5):13-7 [Gorbunkov SD, Varlamov VV, Gichkin AY, Perley VE, Chernyi SM, Romanikhin AI, Syrovnev VA, Agishev AS, Akopov AL. Ultrasonic assessment of diaphragm condition of the patients, who passed the selection for lung volume reduction surgery. Vestnik khirurgii imeni II. Grekova. 2015;174(5):13-7 (In Russ.)]. doi: 10.24884/0042-4625-2015-174-5-13-17
55. Ottenheijm CA, Heunks LM, Dekhuijzen RP. Diaphragm adaptations in patients with COPD. Respir Res. 2008;9:12. doi: 10.1186/1465-9921-9-12
56. Ottenheijm CA, Heunks LM, Sieck GC, Zhan WZh, Jansen SM, Degens H, et al. Diaphragm dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2005;172:200-5. doi: 10.1164/rccm. 200502-262OC
57. Macklem PT, Macklem DM, De Troyer A. A model of inspiratory muscle mechanics. J Appl Physiol Respir Environ Exerc Physiol. 1983;55:547-57. doi: 10.1152/jappl.1983.55.2.547
58. Clanton TL, Levine S. Respiratory muscle fiber remodeling in chronic hyperinflation: dysfunction or adaptation? J Appl Physiol. 2009;107:324-35. PMID: 19359619
59. Baria MR, Shahgholi L, Sorenson EJ, Harper CJ, Lim KG, Strommen JA, et al. B-mode ultrasound assessment of diaphragm structure and function in patients with COPD. Chest. 2014;146:680-5. doi: 10.1378/chest.13-2306
60. Paulin E, Yamaguti WP, Chammas MC, Shibao S, Stelmach R, Cukier A, et al. Influence of diaphragmatic mobility on exercise tolerance and dyspnea in patients with COPD. Respir Med. 2007;101:2113-8. doi: 10.1016/ j.rmed.2007.05.024
61. Dos Santos Yamaguti WP, Paulin E, Shibao S, Chammas MC, Salge JM, Ribeiro M, et al. Air trapping: the major factor limiting diaphragm mobility in chronic obstructive pulmonary disease patients. Respirology. 2008;13:138-44. doi: 10.1111/j.1440-1843.2007.01194.x
62. De Troyer A. Effect of hyperinflation on the diaphragm. Eur Respir J. 1997;10:708-13. doi: 10.1183/09031936.97.100307
63. Whitelaw WA, Hajdo LE, Wallace JA. Relationships among pressure, tension, and shape of the diaphragm. J Appl Physiol. 1983;62:180-6. doi: 10.1152/jappl.1983.55.6.1899
64. Similowski T, Duguet A, Prodanovic H, Straus C. Exploration du diaphragm en réanimation. Réanimation. 2003;12:6-18.
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Авторы
Г.В. Неклюдова 1,2, С.Н. Авдеев 1,2
1 ФГБУ «Научно-исследовательский институт пульмонологии» ФМБА России, Москва, Россия;
2 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
1 Pulmonology Scientific Research Institute under Federal Medical and Biological Agency of Russsian Federation, Moscow, Russia;
2 I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
1 ФГБУ «Научно-исследовательский институт пульмонологии» ФМБА России, Москва, Россия;
2 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
________________________________________________
1 Pulmonology Scientific Research Institute under Federal Medical and Biological Agency of Russsian Federation, Moscow, Russia;
2 I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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