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Diaphragmatic Ultrasound in Adults: Image Acquisition and Interpretation
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Changes in diaphragmatic ultrasonography findings and their association with postoperative complications in children

Ji-Hyun Lee1, Pyoyoon Kang, Jung-Bin Park

  • 1From the Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

European Journal of Anaesthesiology
|October 12, 2023
PubMed

Insights

Postoperative pulmonary complications in children after lung resection are linked to reduced diaphragmatic function. Ultrasound assessment of diaphragmatic excursion and thickening fraction can help predict these complications.

Area of Science:

  • Pediatric Surgery
  • Pulmonology
  • Medical Imaging

Background:

  • Limited research exists on diaphragmatic function changes post-lung resection in children.
  • Postoperative pulmonary complications (PPCs) are a concern in pediatric lung surgery.

Purpose of the Study:

  • To evaluate diaphragmatic function using ultrasound after pediatric lung resection.
  • To determine the association between diaphragmatic function and PPCs in children.

Main Methods:

  • Prospective observational study in a tertiary children's hospital.
  • Ultrasonographic measurements of diaphragmatic excursion (DE) and thickening fraction (TF) were taken before surgery, 1 hour postoperatively, and 24 hours postoperatively.
  • Calculated ratios of postoperative to preoperative DE and TF, and assessed PPC incidence.

Main Results:

  • Diaphragmatic excursion and thickening fraction on the operated side decreased postoperatively and showed limited recovery at 24 hours.
  • Children who developed PPCs had significantly lower DE and TF ratios on the operated side compared to those without PPCs.
  • A DE ratio of < 61.1% on the operated side was associated with PPCs (AUC = 0.764).

Conclusions:

  • Diaphragmatic function assessed by ultrasound changes significantly after pediatric lung resection.
  • Prolonged decrease in diaphragmatic excursion postoperatively is associated with increased risk of pulmonary complications.
Abstract

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