Возможности ультразвукового исследования диафрагмы
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Nekludova G.V., Avdeev S.N. Possibilities of ultrasound research of the diaphragm. Therapeutic Archive. 2019; 91 (3): #–92. DOI: 10.26442/00403660.2019.03.000129
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Ключевые слова: диафрагма, ультразвуковое исследование, болезни органов дыхания.
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The ultrasound method is a non-invasive and safe diagnostic method. Ultrasound examination (ultrasound) of the diaphragm allows you to conduct a direct study of its structure and function. Using stationary and portable ultrasound scanners, the study of the diaphragm can be carried out in specialized laboratories, in outpatient departments, in various departments of the clinic, including in intensive care units, in patients in different clinical conditions. Ultrasound of the diaphragm can be implemented on devices of different technical levels. Despite the fact that at present the diaphragm ultrasound method is not standardized, nevertheless, it provides clinically important information for solving various clinical studies, including when conducting dynamic observation.
Keywords: diaphragm, ultrasonography, respiratory diseases.
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1. Mead J, Loring SH. Analysis of volume displacement and length changes of the diaphragm during breathing. J Appl Physiol. 1982;53:750-5. doi: /10.1152/jappl.1982.53.3.750
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
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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
________________________________________________
G.V. Nekludova 1,2, S.N. Avdeev 1,2
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