Journal Article Epublish
PubMed: 42930637 DOI: 10.3390/jimaging12100486
Multimodal Ultrasound Assessment of the Diaphragm During the Maximal Inspiratory Pressure Maneuver.
J Imaging 12(10)
Authors: Joao Leote, Daniela Nunes, Inês Oliveira, Rafael Silva, Marco Pereira, Jacobo Bacariza, Filipe Gonzalez, Hermínia Dias
Affiliations
- Escola Superior de Saúde de Lisboa, Universidade Politécnica de Lisboa, 1990-096 Lisbon, Portugal.
- Unidade Local de Saúde de Almada-Seixal, Critical Care Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal.
- Escola Superior de Saúde de Lisboa, Universidade Politécnica de Lisboa, 1990-096 Lisbon, Portugal. Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal. Pulmonology Department, Hospital da Luz Lisboa, 1500-650 Lisbon, Portugal.
Abstract
Diaphragm ultrasound (DU) is increasingly used to assess diaphragmatic function, but its relationship with maximal inspiratory pressure (MIP), particularly when both are acquired during the same maneuver, remains unclear. This exploratory cross-sectional study investigated associations between MIP and DU parameters, compared diaphragmatic strain obtained with two different probes and imaging planes, and explored the association between diaphragmatic strain and the diaphragm thickening fraction (TF). Eleven healthy participants (median age 21 years; median body mass index 22.1 kg/m 2) with normal phrenic nerve conduction, transcranial magnetic stimulation, and occlusion pressure at 100 ms underwent DU during the MIP maneuver using phased-array and linear probes at the subcostal window and zone of apposition, respectively. Each ultrasound acquisition was paired with an MIP recorded simultaneously during that acquisition; the two probes were therefore studied within the same session and not during a single shared maneuver. No a priori sample size or power calculation was performed. MIP showed moderate positive associations with diaphragmatic excursion (DE) (r s = 0.603, p = 0.050) and TF (r s = 0.482, p = 0.133), and moderate negative associations with time to peak diaphragmatic excursion (TPDE) (r s = -0.400, p = 0.223) and linear-probe strain (r s = -0.469, p = 0.241). Linear-probe strain was strongly associated with TF (r s = -0.710, p = 0.048). Every bootstrap 95% confidence interval included zero. In this exploratory sample, DE and TF showed the strongest associations with MIP, while zone-of-apposition strain was strongly associated with TF; they merit evaluation as part of a multimodal DU assessment, as candidate quantitative parameters rather than validated markers.
MeSH
Maximal Respiratory Pressures, Diaphragm