| ORIGINAL ARTICLE |
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| Year : 2023 | Volume
: 6
| Issue : 1 | Page : 2-6 |
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Assessment of excursion and thickness of diaphragm by ultrasound during acute exacerbation of chronic obstructive pulmonary disease and correlation with severity of airway obstruction
M Vishnu Sharma1, SR Chandrik Babu2
1 Department of Respiratory Medicine, A. J. Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
2 Department of Respiratory Medicine, Chamarajanagar Institute of Medical Sciences, Yadapura, Karnataka, India
Correspondence Address:
Dr. M Vishnu Sharma
Department of Respiratory Medicine, A. J. Institute of Medical Sciences and Research Centre, Kuntikana, Mangalore, Karnataka
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/japt.japt_38_22
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Background: Diaphragm dysfunction in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) leads to increased morbidity and mortality. Early diagnosis of diaphragm dysfunction and aggressive management to improve the diaphragm function and may improve the outcome in AECOPD. Aims and Objectives: This study aimed to assess diaphragmatic excursion by ultrasound during AECOPD and correlation with the severity of airway obstruction. Materials and Methods: Sixty patients admitted with AECOPD were evaluated. Ultrasonography was done to assess the diaphragm excursion and thickness. Airway obstruction was classified as moderate, severe, and very severe by measuring forced expiratory volume in 1 s (FEV1). Comparison of excursion and thickness of the diaphragm in the study patients was done with normal values and analyzed using Student's t-test. Values of measured FEV1 were correlated with the normal values of excursion and thickness of the diaphragm and statistical analysis was done by ANOVA test. Results: Forty-six males and four females were included in the study. Thirty-four percent (17) had moderate COPD, 60% (30) had severe COPD, and 6% (3) had very severe COPD. The mean excursion and thickness of the diaphragm in the study patients were less when compared to the normal values. In moderate COPD, the mean excursion of the diaphragm was 29.94 mm, whereas in those with severe and very severe COPD, the mean excursions were 26.77 mm and 23.33 mm, respectively. Statistical analysis by ANOVA test was done to compare the diaphragm excursion and severity of COPD. The P = 0.039 was considered statistically significant. Patients with moderate COPD (34%) showed a mean diaphragm thickness of 2.82 mm, and those with severe (60%) and very severe (6%) COPD showed a diaphragm thickness of 2.23 mm and 2.00 mm, respectively. Statistical analysis by ANOVA test was done to compare the diaphragm thickness and severity of COPD. The P < 0.001 was considered statistically significant. Conclusions: Patients with AECOPD have reduced excursion and thickness of the diaphragm in comparison with normal subjects. Diaphragm dysfunction increases as the severity of airflow obstruction in COPD increases.
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