Academic Journal
Point of Care Ultrasound to Identify Diaphragmatic Dysfunction after Thoracic Surgery
| العنوان: | Point of Care Ultrasound to Identify Diaphragmatic Dysfunction after Thoracic Surgery |
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| المؤلفون: | Spadaro S, Grasso S, Dres M, Fogagnolo A, Dalla Corte F, Tamburini N, Maniscalco P, Cavallesco G, Alvisi V, Stripoli T, DE CAMILLIS, ENRICO, Ragazzi R, Volta CA. |
| المساهمون: | Spadaro, S, Grasso, S, Dres, M, Fogagnolo, A, Dalla Corte, F, Tamburini, N, Maniscalco, P, Cavallesco, G, Alvisi, V, Stripoli, T, DE CAMILLIS, Enrico, Ragazzi, R, Volta, Ca. |
| سنة النشر: | 2019 |
| المجموعة: | Università degli Studi di Ferrara: CINECA IRIS |
| مصطلحات موضوعية: | Postoperative diaphragmatic dysfunction, thoracic surgery, postoperative pulmonary complications, video-assisted thoracoscopic surgery, thoracotomy, ultrasound evaluation |
| الوصف: | WHAT WE ALREADY KNOW ABOUT THIS TOPIC: Patients undergoing thoracic surgery are at high risk for postoperative pulmonary complications. The feasibility of using point of care ultrasound to diagnose diaphragmatic dysfunction is unclear. WHAT THIS ARTICLE TELLS US THAT IS NEW: Point of care ultrasound can be used to detect diaphragmatic dysfunction after thoracic surgeryDiaphragmatic dysfunction may be associated with postoperative pulmonary complications BACKGROUND: Postoperative diaphragmatic dysfunction after thoracic surgery is underestimated due to the lack of reproducible bedside diagnostic methods. We used point of care ultrasound to assess diaphragmatic function bedside in patients undergoing video-assisted thoracoscopic or thoracotomic lung resection. Our main hypothesis was that the thoracoscopic approach may be associated with lower incidence of postoperative diaphragm dysfunction as compared to thoracotomy. Furthermore, we assessed the association between postoperative diaphragmatic dysfunction and postoperative pulmonary complications. METHODS: This was a prospective observational cohort study. Two cohorts of patients were evaluated: those undergoing video-assisted thoracoscopic surgery versus those undergoing thoracotomy. Diaphragmatic dysfunction was defined as a diaphragmatic excursion less than 10 mm. The ultrasound evaluations were carried out before (preoperative) and after (i.e., 2 h and 24 h postoperatively) surgery. The occurrence of postoperative pulmonary complications was assessed up to 7 days after surgery. RESULTS: Among the 75 patients enrolled, the incidence of postoperative diaphragmatic dysfunction at 24 h was higher in the thoracotomy group as compared to video-assisted thoracoscopic surgery group (29 of 35, 83% vs. 22 of 40, 55%, respectively; odds ratio = 3.95 [95% CI, 1.5 to 10.3]; P = 0.005). Patients with diaphragmatic dysfunction on the first day after surgery had higher percentage of postoperative pulmonary complications (odds ratio = 5.5 [95% CI, 1.9 to 16.3]; P = 0.001). ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | ELETTRONICO |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/31166236; info:eu-repo/semantics/altIdentifier/wos/WOS:000475696900010; volume:131; issue:2; firstpage:266; lastpage:278; numberofpages:13; journal:ANESTHESIOLOGY; http://hdl.handle.net/11392/2406950; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85070025940; https://pubs.asahq.org/anesthesiology/article/131/2/266/18062/Point-of-Care-Ultrasound-to-Identify-Diaphragmatic |
| DOI: | 10.1097/ALN.0000000000002774 |
| الاتاحة: | http://hdl.handle.net/11392/2406950 https://doi.org/10.1097/ALN.0000000000002774 https://pubs.asahq.org/anesthesiology/article/131/2/266/18062/Point-of-Care-Ultrasound-to-Identify-Diaphragmatic |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.7151C72F |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/ALN.0000000000002774 |
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