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Updated: Jun 20, 2026
05:51
Measuring Diaphragm Thickness and Function Using Point-of-Care Ultrasound
Published on: November 3, 2023
Diaphragmatic Thickening Fraction and Excursion: Different Clinical Values in Non-Critically Ill Patients with AECOPD
Xun Yang1, Liangdong Zhu2, Ruijie Ren3
1Department of Respiratory and Critical Care Medicine, Chongqing Hospital of Jiangsu Province Hospital, Chongqing, 401420, People's Republic of China.
Summary
Diaphragmatic thickening fraction (DTF) and excursion (DE) ultrasound measurements in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients show distinct clinical values. Elevated DTF predicts non-invasive ventilation (NIV) need, while DE indicates NIV treatment response.
Area of Science:
- Pulmonary Medicine
- Critical Care Medicine
- Diagnostic Ultrasound
Background:
- Diaphragm dysfunction is a primary cause of respiratory failure in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
- Ultrasound parameters like diaphragmatic thickening fraction (DTF) and diaphragmatic excursion (DE) are used to assess diaphragm function.
- The clinical utility of DTF and DE in non-critically ill AECOPD patients requires further investigation.
Purpose of the Study:
- To evaluate the association between early ultrasound-assessed DTF and DE and the need for non-invasive ventilation (NIV) in AECOPD patients.
- To determine if DTF and DE can predict treatment response in AECOPD patients receiving NIV.
- To assess the independent predictive value of DTF beyond established clinical factors.
Main Methods:
- A retrospective observational study involving 123 AECOPD patients admitted between December 2025 and January 2026.
- DTF and DE were measured within 24 hours of admission and prior to NIV initiation.
- Multivariable logistic regression was employed to analyze the association of DTF with NIV requirement and treatment response.
Main Results:
- Higher DTF was observed in patients requiring NIV compared to those who did not (P=0.033), but DE showed no significant difference.
- After adjusting for clinical predictors, DTF did not independently predict NIV requirement (P=0.121).
- Among NIV recipients, higher DE was associated with better treatment response (P=0.015), while DTF did not differ significantly between responders and non-responders.
Conclusions:
- Elevated DTF in non-critically ill AECOPD patients correlates with NIV necessity but lacks independent predictive power beyond clinical indicators.
- DE appears to be a valuable parameter for assessing NIV treatment response, potentially reflecting diaphragmatic contractile reserve.
- DTF and DE possess distinct clinical implications in AECOPD management, warranting further prospective validation for clinical application.
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