Banjade P, Rijal Y, Sharma M, Surani S. Role of diaphragmatic ultrasound in patients with acute exacerbation of chronic obstructive pulmonary disease. World J Clin Cases 2024; 12(36): 6887-6891 [PMID: 39726933 DOI: 10.12998/wjcc.v12.i36.6887]
Corresponding Author of This Article
Salim Surani, FACP, FCCP, MD, MHSc, Professor, Department of Medicine and Pharmacology, Texas A and M University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Prakash Banjade, Department of General Medicine, Manipal College of Medical Science, Pokhara 33700, Nepal
Yasoda Rijal, Department of Internal Medicine, Institute of Medicine Tribhuvan University, Kathmandu 44613, Nepal
Munish Sharma, Department of Pulmonary and Critical Care Medicine, Baylor Scott and White, Temple, LA 76508, United States
Salim Surani, Department of Medicine and Pharmacology, Texas A and M University, College Station, TX 77843, United States
Author contributions: Bandaje P, Yasoda R and Sharma M were involved in review of literature and writeup; Surani S was involved in originator, supervision, review and revision of the manuscript; all of the authors read and approved the final version of the manuscript to be published.
Conflict-of-interest statement: None of the authors have any conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, FACP, FCCP, MD, MHSc, Professor, Department of Medicine and Pharmacology, Texas A and M University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Received: August 15, 2024 Revised: September 8, 2024 Accepted: September 13, 2024 Published online: December 26, 2024 Processing time: 76 Days and 19.1 Hours
Abstract
Assessing diaphragm function status is vital for diagnosing and treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Diaphrag-matic ultrasound has become increasingly important due to its non-invasive nature, absence of radiation exposure, widespread availability, prompt results, high accuracy, and repeatability at the bedside. The diaphragm is a crucial respiratory muscle. Decline or dysfunction of the diaphragm can lead to dyspnea and even respiratory failure in AECOPD patients. In this editorial, we comment on an article, retrospectively analyzed ninety-four acute exacerbations of chronic obstructive pulmonary disease patients who received mechanical ventilation from January 2022 to December 2023. The study found that the diaphragm thickening fraction, an index from diaphragm ultrasound, can better predict the outcome of non-invasive ventilation in patients with AECOPD. The value of non-invasive ventilation in treating respiratory failure caused by AECOPD has been widely acknowledged. Diaphragmatic dysfunction diagnosed with ultrasound is associated with prolonged mechanical ventilation and weaning times and higher mortality.
Core Tip: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) could lead to respiratory failure, increasing the patient's morbidity and mortality. Diaphragmatic ultrasound could be an important tool to predict better the outcome of noninvasive ventilation in patients with AECOPD. Diaphragmatic indices such as diaphragm activity, diaphragm movement time index, and diaphragm thickening fraction can be assessed with ultrasonography, which could predict the mechanical ventilation outcomes in AECOPD patients.
