Role of diaphragmatic ultrasound in patients with acute exacerbation of chronic obstructive pulmonary disease

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.

Keywords: Diaphragm ultrasound; Chronic obstructive pulmonary disease; Diaphragm; Ultrasound; Obstructive lung disease; Nivalenol; Respiratory failure; mechanical ventilation

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.