[Diaphragmatic ultrasonography for the pulmonologist: Technique and clinical use]

Abstract

Introduction: Ultrasonography is an emerging tool that helps to assess diaphragmatic function. It is now widely used in ICUs to predict weaning from mechanical ventilation. Ultrasonography is readily available, harmless (no radiation), and repeatable with good interoperator reproducibility. Over the past few years, ultrasonography has seen increasing use in patients with chronic pulmonary pathologies.

State of the art: The aim of this review is (1) to describe the ultrasound techniques used to assess diaphragmatic excursion and thickening, (2) to indicate the expected, normal values in healthy patients, and (3) to summarize the main findings and clinical applications in treatment of chronic respiratory disorders.

Conclusions: Chronic pulmonary diseases are associated with diaphragmatic dysfunction that can be assessed with ultrasound. Diaphragmatic dysfunction is primary in neuromuscular disorders and secondary to respiratory disease in other chronic pulmonary conditions (COPD, ILD). Ultrasound is correlated with the severity of the underlying disease (functional and clinical parameters).

Perspectives: The prognostic interest of diaphragm ultrasonography remains to be established, after which its utilization should become routine.

Keywords: Bronchopneumopathie obstructive chronique; Chronic obstructive pulmonary disease; Diaphragmatic ultrasonography; Interstitial lung diseases; Maladies neuromusculaires; Neuromuscular diseases; Pneumopathies interstitielles diffuses; Échographie diaphragmatique.