Speckle tracking ultrasound as a new tool to assess diaphragmatic function: a feasibility study
Sebastian Johannes Fritsch1 , Nima Hatam2, Andreas Goetzenich2 , Gernot Marx1 , Ruediger Autschbach2, Leo Heunks3 , Johannes Bickenbach1 , Christian Simon Bruells4
1Department of Intensive Care Medicine, University hospital RWTH Aachen, Aachen, Germany
2Department of Thoracic and Cardio-Vascular Surgery, University hospital RWTH Aachen, Aachen, Germany
3Department of Intensive Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
4Department of Anesthesiology, University hospital RWTH Aachen, Aachen, Germany
Corresponding Author: Sebastian Johannes Fritsch ,Tel: +492418080444, Fax: +49241803380444, Email: sfritsch@ukaachen.de
Received: February 25, 2021;  Accepted: August 17, 2021.  Published online: August 17, 2021.
ABSTRACT
A reliable measuring method of diaphragmatic function at bedside is still lacking. Widely used two-dimensional (2D) sonographic measurements, like diaphragm excursion, diaphragm thickness and fractional thickening (FT) failed to show a clear correlation to diaphragmatic function. 2D sonographic measurements, like FT, are merely able to measure the deformation of muscular diaphragmatic tissue in transversal direction, while a longitudinal measurement in direction of contracting muscle fibres is not possible. Speckle tracking sonography, which is widely used in cardiac imaging to date, overcomes this disadvantage and allows observing a movement in direction of the contracting muscle fibres approximating muscle deformation and its deformation velocity. In several studies, speckle tracking was evaluated as a promising method to assess the diaphragm contractility in healthy subjects. In this technical note, we demonstrate the feasibility of speckle tracking sonography of the diaphragm in a group of 20 patients after aortocoronary bypass graft procedure. Based on our results, presented herein, we suggest that speckle tracking sonography is able to depict alterations in diaphragmatic function after surgery better than 2D sonographic measurements.
Keywords: Diaphragm; Ultrasonography; Speckle tracking ultrasound; Fractional thickening
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