Assessing diaphragm function by ultrasound in amyotrophic lateral sclerosis (ALS) patients

F. Viccaro (ROMA, Italy), L. D'Antoni (ROMA, Italy), M. Cardini (ROMA, Italy), R. Flore (ROMA, Italy), C. Tomsa (ROMA, Italy), A. Lecci (ROMA, Italy), A. Tramontano (ROMA, Italy), P. Palange (ROMA, Italy)

Source: Respiratory Failure and Mechanical Ventilation Conference 2022 - Opening session: Essentials of respiratory physiology - Assessment of respiratory muscle function - Pulmonary infections in mechanically ventilated patients - Telemonitoring of patients with chronic respiratory failure - Diagnostics and interventions - Acute respiratory failure: COVID-19 - Interstitial lung disease and pulmonary hypertension - Early rehabilitation - Acute respiratory failure: Invasive mechanical ventilation - HFNO and NIV for acute hypoxemic failure - Longterm NIV miscellaneous - Controversies in acute respiratory failure - The role of respiratory muscle dysfunction in weaning failure - Transitions in chronic NIV - New insights in weaning from invasive ventilation - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Difficult weaning from mechanical ventilation - Chronic ventilatory support in different diseases: Is one way fitting all? - Strategies to optimise early mobilisation and rehabilitation in intensive care - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Acute respiratory failure: Hypercapnic and diagnosis - Weaning from mechanical ventilation - Mechanical ventilation in the acute setting - Health-related quality of life in mechanical ventilation - Long-term noninvasive ventilation: Diagnosis and outcome

Session: Long-term noninvasive ventilation: Diagnosis and outcome
Session type: Oral poster discussion
Number: 125

Abstract

To identify the onset of diaphragm dysfunction in Amyotrophic Lateral Sclerosis (ALS) patients, respiratory functional tests (RFT) are the most valid parameters to detect hypoventilation in ALS, although require collaboration. Otherwise, diaphragm ultrasound (DUS) is a non-volitional technique, bed-side and radiation-free able to assess diaphragm function. This study correlates DUS with the respiratory function tests to evaluate ventilatory dysfunctions in ALS patients.

This study enrolled 29 spinal ALS and 13 healthy patients. All patients performed respiratory functional tests and DUS to assess diaphragmatic excursion, delta-thickness (?T), and thickening fraction (TF).

Diaphragmatic excursion correlates significantly with both VC % in upper (r=0,54; p=0,007) and supine (r=0,58; p=0,003;) position; and FVC % in upper (r=0,65; p=0,0007) and supine (r=0,63; p=0,001;) position. The excursion also correlates with MIP (r=0,42; p=0,04) and SNIP (r=0,43; p=0,05). Both delta-thickness (?T) and thickening fraction (TF) correlate respectively with VC % in upper (r=0,58; p=0,001 and r=0,55; p=0,003) and supine (r=0,59; p=0,001 and r=0,55; p=0,003) position; and FVC % in upper (r=0,61; p=0,0008 and r=0,53; p=0,005) and supine position (r=0,62; p=0,0006 and r=0,51; p=0,007).

In conclusion, diaphragmatic excursion, delta-thickness (?T) and thickening fraction (TF) significantly correlate with lung function impairments in ALS patients.

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Citations should be made in the following way:
F. Viccaro (ROMA, Italy), L. D'Antoni (ROMA, Italy), M. Cardini (ROMA, Italy), R. Flore (ROMA, Italy), C. Tomsa (ROMA, Italy), A. Lecci (ROMA, Italy), A. Tramontano (ROMA, Italy), P. Palange (ROMA, Italy). Assessing diaphragm function by ultrasound in amyotrophic lateral sclerosis (ALS) patients. Respiratory Failure and Mechanical Ventilation Conference 2022 - Opening session: Essentials of respiratory physiology - Assessment of respiratory muscle function - Pulmonary infections in mechanically ventilated patients - Telemonitoring of patients with chronic respiratory failure - Diagnostics and interventions - Acute respiratory failure: COVID-19 - Interstitial lung disease and pulmonary hypertension - Early rehabilitation - Acute respiratory failure: Invasive mechanical ventilation - HFNO and NIV for acute hypoxemic failure - Longterm NIV miscellaneous - Controversies in acute respiratory failure - The role of respiratory muscle dysfunction in weaning failure - Transitions in chronic NIV - New insights in weaning from invasive ventilation - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Difficult weaning from mechanical ventilation - Chronic ventilatory support in different diseases: Is one way fitting all? - Strategies to optimise early mobilisation and rehabilitation in intensive care - Noninvasive ventilation (NIV) in the clinical practice: How do I do it? - Acute respiratory failure: Hypercapnic and diagnosis - Weaning from mechanical ventilation - Mechanical ventilation in the acute setting - Health-related quality of life in mechanical ventilation - Long-term noninvasive ventilation: Diagnosis and outcome

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