Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
European Center for AngioScience (ECAS), German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, and Centre for Cardiovascular Acute Medicine Mannheim (ZKAM), Medical Centre Mannheim, Heidelberg University, Mannheim, Germany.
BMC Pulm Med. 2024 Jun 21;24(1):289. doi: 10.1186/s12890-024-03096-5.
The diaphragm thickening fraction (DTF) may be a valuable tool for estimating respiratory effort in non-invasive ventilation. The primary aim of this physiological study is the investigation of the correlation of DTF with oesophageal pressure swings (ΔP). A secondary aim is to assess the discriminatory capacity of the index tests for different exercise loads.
Healthy volunteers underwent spontaneous breathing and non-invasive ventilation with a sequence of different respirator settings. The first sequence was carried out at rest. The same sequence was repeated twice, with additional ergometry of 25 and 50 Watts, respectively. DTF and ΔP were measured during each ventilation configuration.
23 individuals agreed to participate. DTF was moderately correlated with ΔP (repeated measures correlation ρ = 0.410, p < 0.001). Both ΔP and DTF increased consistently with exercise loading in every ventilation configuration, however ΔP showed greater discriminatory capacity.
DTF was moderately correlated with ΔP and could discriminate reasonably between exercise loads in a small cohort of non-invasively ventilated healthy subjects. While it may not accurately reflect the absolute respiratory effort, DTF might help titrating individual non-invasive respiratory support. Further investigations are needed to test this hypothesis.
This study was not prospectively registered.
膈肌增厚分数（DTF）可能是评估无创通气中呼吸努力的有用工具。本生理研究的主要目的是研究 DTF 与食管压力波动（ΔP）的相关性。次要目的是评估该指数测试对不同运动负荷的区分能力。
健康志愿者在休息时进行自主呼吸和无创通气，并进行一系列不同的呼吸机设置。第一个序列是在休息时进行的。相同的序列重复了两次，分别增加了 25 和 50 瓦特的运动负荷。在每个通气配置期间测量 DTF 和 ΔP。
23 名个人同意参与。DTF 与 ΔP 呈中度相关（重复测量相关 ρ=0.410，p<0.001）。在每种通气配置下，ΔP 和 DTF 都随着运动负荷的增加而持续增加，但 ΔP 显示出更大的区分能力。
DTF 与 ΔP 中度相关，在小队列的无创通气健康受试者中可以合理地区分运动负荷。虽然它可能无法准确反映绝对呼吸努力，但 DTF 可能有助于调整个体的无创呼吸支持。需要进一步的研究来验证这一假设。
本研究没有前瞻性注册。
