100 Section - Diaphragm Relaxation Ultrasound Diagnosis: Relevance for Clinical Practice in Respiratory Function

Diaphragm relaxation is often overlooked in clinical assessments within the field of respirology, yet it plays a crucial role in heart function and overall posture. Additionally, it can facilitate ultrasound-guided punctures of pleural cavities and abdominal organs such as the liver, stomach, and kidneys. Diaphragm relaxation can be effectively assessed using ultrasound (US), and the role of the phrenic nerve in this context remains understudied. This nerve can be visualized and assessed using US.

The aim of this study was to investigate the significance of diaphragm relaxation ultrasound diagnosis in the clinical context for assessing respiratory function.

Design: We conducted a retrospective analysis of 20 cases, comprising patients aged between 30 and 78 years, all of whom had been diagnosed with various respiratory diseases, including pneumonia and lung lesions. All patients underwent an extensive diagnostic protocol, including thoracic and abdominal US with the use of M-mode.

Results:

Among the cases, 18 exhibited an increased diaphragm dome, while 2 showed a decrease due to tension from hydrothorax. Hydrothorax was identified in 10 cases, demonstrating the diagnostic utility of diaphragm ultrasound in detecting associated pathologies. Adjustments to puncture sites based on these findings were made. M-mode analysis revealed reduced diaphragm movement in relaxation sites. Lesions at the neck level with ultrasound signs of phrenic nerve involvement were identified in six patients. Cases involving larynx tumors, lymph node pathologies, and esophageal cancers at the neck level were also observed. Increased abdominal pressure correlated with a higher diaphragm position, indicating potential puncture sites.

Conclusion: This study underscores the importance of diaphragm relaxation ultrasound as a valuable tool for diagnosing and understanding respiratory conditions, particularly in cases where its relevance is often underestimated. Incorporating this technique into clinical practice can enhance the accuracy of respiratory assessments and contribute to improved patient care.