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ORIGINAL RESEARCH article

Front. Med.
Sec. Pulmonary Medicine
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1532214
This article is part of the Research Topic Advances in Lung Ultrasound: From Child to Adulthood Diseases - Volume II View all 3 articles

Ultrasound analysis of hemidiaphragm function in case of pleural effusion

Provisionally accepted
Martin Boussuges Martin Boussuges 1,2Fabienne Bregeon Fabienne Bregeon 2,3Xavier Benoit D'Journo Xavier Benoit D'Journo 4Alain Boussuges Alain Boussuges 2,5*
  • 1 Centre Hospitalier Universitaire de la Réunion Sud, Saint Pierre, France
  • 2 Services des Explorations Fonctionnelles Respiratoires, APHM, Hôpital Nord, Marseille, France
  • 3 Unité d’Appui à la recherche (HIPE), Aix-Marseille Université, CNRS, Université de Toulon, Institut Paoli-Calmettes,, Marseille, Provence-Alpes-Côte d'Azur, France
  • 4 Service de Chirurgie Thoracique et Maladies Oesophagiennes, Hôpital Nord, Marseille, Provence-Alpes-Côte d'Azur, France
  • 5 Centre de recherche en CardioVasculaire et Nutrition, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, Marseille, Provence-Alpes-Côte d'Azur, France

The final, formatted version of the article will be published soon.

    Most of the various circumstances and diseases that may be responsible for pleural effusion are also risk factors for phrenic nerve conduction or respiratory muscle impairment, which causes diagnostic difficulties. The objective of this retrospective observational study was to determine predictive ultrasound criteria for the mechanism of diaphragm dysfunction in case of pleural effusion. When the amount of pleural fluid is large, a hemidiaphragm paralysis profile can be observed. The regression of paradoxical movement in supine position, associated with the detection of significant inspiratory thickening is in favor of unimpaired diaphragm muscle function. In moderate pleural effusion, a decrease in pleural fluid-induced excursion is frequently observed. In contrast, when a hemidiaphragm paralysis profile is found, an impairment in diaphragmatic function may be expected. In small pleural effusion, when the muscle function of the hemidiaphragm is preserved, the excursion measured during deep breathing should reach the lower limit of normal. Our study highlights the interest to combine the analysis of diaphragm excursion and thickening in both sitting and supine positions to assess the impact of pleural effusion and detect impaired diaphragm muscle function. This study adds new important data to accurately assess diaphragmatic function in case of pleural effusion.

    Keywords: Diaphragm, Chest ultrasonography, dysfunction, Normal value, anatomical Mmode

    Received: 21 Nov 2024; Accepted: 27 Dec 2024.

    Copyright: © 2024 Boussuges, Bregeon, D'Journo and Boussuges. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Alain Boussuges, Centre de recherche en CardioVasculaire et Nutrition, Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, Marseille, 13005, Provence-Alpes-Côte d'Azur, France

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