Exploring diaphragmatic response to high-flow nasal cannula in patients with COVID-19 pneumonia using ultrasound: a proof of concept study.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Ultrasound Pub Date : 2024-09-01 Epub Date: 2024-07-26 DOI:10.1007/s40477-024-00937-1

Issac Cheong, Federico Matías Álvarez Vilariño, José Patricio Gaggino, Raúl Alejandro Gómez, Francisco Marcelo Tamagnone

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引用次数: 0

Abstract

Background: Recent studies have highlighted the recognition of diaphragmatic dysfunction as a significant factor contributing to respiratory disturbances in severely ill COVID-19 patients. In the field of noninvasive respiratory support, high-flow nasal cannula (HFNC) has shown effectiveness in relieving diaphragm dysfunction. This study aims to investigate the diaphragmatic response to HFNC in patients with COVID-19 pneumonia by utilizing ultrasound.

Methods: This retrospective study was conducted in a medical-surgical intensive care unit (ICU) at a tertiary care center in Buenos Aires, Argentina (Sanatorio de Los Arcos) over a 16-month period (January 2021-June 2022). The study included patients admitted to the ICU with a diagnosis of COVID-19 pneumonia who were deemed suitable candidates for HFNC therapy by the attending physician. Diaphragm ultrasound was conducted, measuring diaphragmatic excursion (DE) both before and during the utilization of HFNC for these patients.

Results: A total of 10 patients were included in the study. A statistically significant decrease in respiratory rate was observed with the use of HFNC (p = 0.02), accompanied by a significant increase in DE (p = 0.04).

Conclusion: HFNC leads to a reduction in respiratory rate and an increase in DE as observed by ultrasound in patients with COVID-19 pneumonia, indicating promising enhancements in respiratory mechanics. However, further research is required to validate these findings.

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利用超声波探索 COVID-19 肺炎患者对高流量鼻插管的膈肌反应：概念验证研究。

背景：最近的研究强调，膈肌功能障碍是导致 COVID-19 重症患者呼吸紊乱的一个重要因素。在无创呼吸支持领域，高流量鼻插管（HFNC）已显示出缓解横膈膜功能障碍的有效性。本研究旨在利用超声波调查 COVID-19 肺炎患者对 HFNC 的膈肌反应：这项回顾性研究在阿根廷布宜诺斯艾利斯一家三级医疗中心（Sanatorio de Los Arcos）的内外科重症监护病房（ICU）进行，为期 16 个月（2021 年 1 月至 2022 年 6 月）。研究对象包括重症监护室收治的诊断为 COVID-19 肺炎且主治医生认为适合接受高频核磁疗法的患者。在这些患者使用 HFNC 之前和期间进行了膈肌超声检查，测量膈肌偏移（DE）：结果：共有 10 名患者参与了研究。使用 HFNC 后，呼吸频率明显降低（p = 0.02），同时膈肌张力明显增加（p = 0.04）：结论：通过超声波观察，HFNC 可降低 COVID-19 肺炎患者的呼吸频率并增加 DE，这表明呼吸力学有望得到改善。结论：COVID-19 肺炎患者通过超声波观察到 HFNC 可降低呼吸频率和增加 DE，这表明呼吸力学有望得到改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.10

自引率

15.00%

发文量

133

期刊介绍： The Journal of Ultrasound is the official journal of the Italian Society for Ultrasound in Medicine and Biology (SIUMB). The journal publishes original contributions (research and review articles, case reports, technical reports and letters to the editor) on significant advances in clinical diagnostic, interventional and therapeutic applications, clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and in cross-sectional diagnostic imaging. The official language of Journal of Ultrasound is English.