Assessment of Diaphragmatic Mobility by Transthoracic Ultrasound in Patients with Interstitial Lung Diseases

Background : Interstitial lung diseases (ILDs) may promote respiratory muscle dysfunction due to increased lung elastic recoil, chronic hypoxemia, systemic in fl ammation, physical inactivity, malnutrition, and corticosteroid therapy. Therefore, measuring diaphragmatic function is quite helpful when assessing patients with ILDs. Aim : The aim of the study was to compare diaphragmatic mobility which was assessed by ultrasonography between healthy individuals and patients with ILDs. Patients and methods : This is a case e control trial, where 30 patients with clinically stable ILDs and 20 healthy persons served as a control. Age, sex, and BMI matched apparently in the control group. Pulmonary function tests such as the 6-min walk test, ultrasonographic measurement of both diaphragmatic excursion, and thicknesses at residual functional capacity and total lung capacity (TLC), with a calculation of the diaphragmatic thickening fraction were done for all participants. Results : Diaphragmatic kinetics are greatly impaired in ILD patients at TLC, but almost not affected at functional residual capacity. Diaphragmatic excursion and thickness at TLC and the diaphragmatic thickening fraction showed considerable positive correlations with forced vital capacity and 6-min walk distance, whereas they exhibited considerable negative correlations with modi fi ed Medical Research Council dyspnea scale. Conclusion : Diaphragmatic kinetics measured at TLC and thickening fraction have good correlations with the degree of dyspnea, forced vital capacity, and exercise tolerance.