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A New Method for Diaphragmatic Maximum Relaxation Rate Ultrasonographic Measurement in the Assessment of Patients With Diaphragmatic Dysfunction

Published on Jan 1, 2018in IEEE Journal of Translational Engineering in Health and Medicine
· DOI :10.1109/jtehm.2018.2868671
Chritos P. Loizou18
Estimated H-index: 18
(Cyprus University of Technology),
Dimitrios Matamis15
Estimated H-index: 15
+ 5 AuthorsConstantinos S. Pattichis34
Estimated H-index: 34
(University of Cyprus)
Abstract
Measurements of ultrasound diaphragmatic motion, amplitude, force, and velocity of contraction may provide important and essential information about diaphragmatic fatigue, weakness, or paralysis. In this paper, we propose and evaluate a semi-automated analysis system for measuring the diaphragmatic motion and estimating the maximum relaxation rate (MRR_SAUS) from ultrasound M-mode images of the diaphragmatic muscle. The system was evaluated on 27 M-mode ultrasound images of the diaphragmatic muscle [20 with no resistance (NRES) and 7 with resistance (RES)]. We computed semi-automated ultrasound MRR measurements on all NRES/RES images, using the proposed system (MRR_SAUS = 3.94 ± 0.91/4.98 ± 1.98 [1/s]), and compared them with the manual measurements made by a clinical expert (MRR_MUS = 2.36 ± 1.19/5.8 ± 2.1 [1/s],) and those made by a reference manual method (MRR_MB = 3.93 ± 0.89/3.73 ± 0.52 [1/sec], performed manually with the Biopac system. MRR_SAUS and MRR_MB measurements were not statistically significantly different for NRES and RES subjects but were significantly different with the MRR-MUS measurements made by the clinical expert. It is anticipated that the proposed system might be used in the future in the clinical practice in the assessment and follow up of patients with diaphragmatic weakness or paralysis. It may thus potentially help to understand post-operative pulmonary dysfunction or weaning failure from mechanical ventilation. Further validation and additional experimentation in a larger sample of images and different patient groups is required for further validating the proposed system.
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Published on Jan 1, 2016
Christakis D. Loizou2
Estimated H-index: 2
(Cyprus University of Technology),
Chritos P. Loizou18
Estimated H-index: 18
(Cyprus University of Technology)
+ 3 AuthorsConstantinos S. Pattichis34
Estimated H-index: 34
(University of Cyprus)
Measurements of ultrasound diaphragmatic motion may provide important and essential information about diaphragmatic fatigue. In this work, we propose a semi-automated analysis system for measuring the diaphragmatic motion and estimation of the maximum relaxation rate (MRR) from ultrasound M-mode images of the diaphragmatic muscle. The proposed system was evaluated in three ultrasound images of the diaphragmatic muscle. The system is able to compute the diaphragmatic motion and extract quantitati...
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Published on Dec 1, 2015in Critical Ultrasound Journal
Federico Barbariol4
Estimated H-index: 4
(University of Udine),
Luigi Vetrugno7
Estimated H-index: 7
(University of Udine)
+ 2 AuthorsGiorgio Della Rocca28
Estimated H-index: 28
(University of Udine)
In some intensive care, nowadays, ultrasound diagnostics have become an extension of the physical examination (like a stethoscope). In this report, we discuss the case of an acute respiratory failure which arose immediately after the end of general anesthesia. An initial bedside ultrasound evaluation applying the ‘BLUE protocol’ showed no pathological changes capable of explaining the clinical picture; however, by evaluating also the right and left hemidiaphragms, we made a diagnosis of diaphrag...
3 Citations Source Cite
Published on Aug 1, 2015 in International Conference of the IEEE Engineering in Medicine and Biology Society
Charalambos Chrysostomou6
Estimated H-index: 6
(University of Thessaly),
Christakis D. Loizou2
Estimated H-index: 2
(Cyprus University of Technology)
+ 2 AuthorsConstantinos S. Pattichis34
Estimated H-index: 34
(University of Cyprus)
The motion characteristics of the diaphragmatic muscle may provide useful information about normal and abnormal diaphragmatic function and indicate diaphragmatic weakness. The objective of this paper was to introduce a simple system for the quantitative analysis of ultrasonic diaphragmatic motion. The measurements routinely carried out by the experts were computed and these include: (i) excursion, (ii) inspiration time (Tinsp) and (iii) cycle duration (Ttot). The system was evaluated on four sim...
2 Citations Source Cite
Published on Dec 1, 2014in Critical Ultrasound Journal
Giovanni Ferrari16
Estimated H-index: 16
,
Giovanna De Filippi3
Estimated H-index: 3
+ 3 AuthorsFranco Aprà5
Estimated H-index: 5
Background Predictive indexes of weaning from mechanical ventilation are often inaccurate. Among the many indexes used in clinical practice, the rapid shallow breathing index is one of the most accurate. We evaluated a new weaning index consisting in the diaphragm thickening fraction (DTF) assessed by ultrasound.
71 Citations Source Cite
Published on May 1, 2014in Thorax 9.65
Ernest DiNino3
Estimated H-index: 3
(Memorial Hospital of Rhode Island),
Eric Gartman9
Estimated H-index: 9
(Memorial Hospital of Rhode Island)
+ 1 AuthorsFranklin D. McCool1
Estimated H-index: 1
(Memorial Hospital of Rhode Island)
Introduction The purpose of this study was to evaluate if ultrasound derived measures of diaphragm thickening, rather than diaphragm motion, can be used to predict extubation success or failure. Methods Sixty-three mechanically ventilated patients were prospectively recruited. Diaphragm thickness (tdi) was measured in the zone of apposition of the diaphragm to the rib cage using a 7–10 MHz ultrasound transducer. The percent change in tdi between end-expiration and end-inspiration (Δtdi%) was cal...
115 Citations Source Cite
Published on Jan 1, 2014in Bio-medical Materials and Engineering 0.87
Dong K. Noh1
Estimated H-index: 1
,
Jae J. Lee1
Estimated H-index: 1
,
Joshua H. You10
Estimated H-index: 10
Abstract Recent ultrasound imaging evidence asserts that the diaphragm is an important multifunctional muscle to control breathing as well as stabilize the core and posture in humans. However, the validity and accuracy of ultrasound for the measurement of dynamic diaphragm movements during breathing and functional core activities have not been determined. The specific aim of this study was to validate the accuracy of ultrasound imaging measurements of diaphragm movements by concurrently comparin...
12 Citations Source Cite
Published on Jan 1, 2014in Annals of Rehabilitation Medicine
Kang-Jae Jung1
Estimated H-index: 1
(Eulji University),
Ji Young Park24
Estimated H-index: 24
(Eulji University)
+ 2 AuthorsJae-Hyung Kim1
Estimated H-index: 1
(Eulji University)
Objective To evaluate diaphragmatic motion via M-mode ultrasonography and to correlate it with pulmonary function in stroke patients. Methods This was a preliminary study comprised of ten stroke patients and sixteen healthy volunteers. The M-mode ultrasonographic probe was positioned in the subcostal anterior region of the abdomen for transverse scanning of the diaphragm during quiet breathing, voluntary sniffing, and deep breathing. We analyzed diaphragmatic motion and the relationship between ...
12 Citations Source Cite
Published on May 1, 2013in Intensive Care Medicine 15.01
Dimitrios Matamis15
Estimated H-index: 15
,
Eleni Soilemezi3
Estimated H-index: 3
+ 5 AuthorsLaurent Brochard91
Estimated H-index: 91
(University of Geneva)
The use of ultrasonography has become increasingly popular in the everyday management of critically ill patients. It has been demonstrated to be a safe and handy bedside tool that allows rapid hemodynamic assessment and visualization of the thoracic, abdominal and major vessels structures. More recently, M-mode ultrasonography has been used in the assessment of diaphragm kinetics. Ultrasounds provide a simple, non-invasive method of quantifying diaphragmatic movement in a variety of normal and p...
166 Citations Source Cite
Published on Apr 1, 2013in Respirology 4.41
Eleni Soilemezi3
Estimated H-index: 3
,
Matthew Tsagourias4
Estimated H-index: 4
+ 4 AuthorsDimitrios Matamis1
Estimated H-index: 1
Background and objective Diaphragmatic breathing patterns under resistive loading remain poorly documented. To our knowledge, this is the first study assessing diaphragmatic motion under conditions of inspiratory resistive loading with the use of sonography. Methods We assessed diaphragmatic motion during inspiratory resistive loading in 40 healthy volunteers using M-mode sonography. In phase I of the study, sonography was performed during normal quiet breathing without respiratory loading. In p...
14 Citations Source Cite
Published on Mar 1, 2013in Muscle & Nerve 2.50
Aarti Sarwal9
Estimated H-index: 9
,
Francis O. Walker45
Estimated H-index: 45
,
Michael S. Cartwright30
Estimated H-index: 30
Neuromuscular clinicians are often asked to evaluate the diaphragm for diagnostic and prognostic purposes. Traditionally, this evaluation is accomplished through history, physical exam, fluoroscopic sniff test, nerve conduction studies, and electromyography (EMG). Nerve conduction studies and EMG in this setting are challenging, uncomfortable, and can cause serious complications, such as pneumothorax. Neuromuscular ultrasound has emerged as a non-invasive technique that can be used in the struct...
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