Banjade Prakash, Rijal Yasoda, Sharma Munish, Surani Salim
Department of General Medicine, Manipal College of Medical Science, Pokhara 33700, Nepal.
Department of Internal Medicine, Institute of Medicine Tribhuvan University, Kathmandu 44613, Nepal.
World J Clin Cases. 2024 Dec 26;12(36):6887-6891. doi: 10.12998/wjcc.v12.i36.6887.
Assessing diaphragm function status is vital for diagnosing and treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Diaphrag-matic ultrasound has become increasingly important due to its non-invasive nature, absence of radiation exposure, widespread availability, prompt results, high accuracy, and repeatability at the bedside. The diaphragm is a crucial respiratory muscle. Decline or dysfunction of the diaphragm can lead to dyspnea and even respiratory failure in AECOPD patients. In this editorial, we comment on an article, retrospectively analyzed ninety-four acute exacerbations of chronic obstructive pulmonary disease patients who received mechanical ventilation from January 2022 to December 2023. The study found that the diaphragm thickening fraction, an index from diaphragm ultrasound, can better predict the outcome of non-invasive ventilation in patients with AECOPD. The value of non-invasive ventilation in treating respiratory failure caused by AECOPD has been widely acknowledged. Diaphragmatic dysfunction diagnosed with ultrasound is associated with prolonged mechanical ventilation and weaning times and higher mortality.
评估膈肌功能状态对于慢性阻塞性肺疾病急性加重期（AECOPD）的诊断和治疗至关重要。由于其无创性、无辐射暴露、广泛可用、结果迅速、准确性高以及可在床边重复进行，膈肌超声已变得越来越重要。膈肌是一种关键的呼吸肌。在AECOPD患者中，膈肌功能下降或功能障碍可导致呼吸困难甚至呼吸衰竭。在这篇社论中，我们对一篇文章进行评论，回顾性分析了2022年1月至2023年12月期间接受机械通气的94例慢性阻塞性肺疾病急性加重期患者。该研究发现，膈肌超声指标膈肌增厚分数能够更好地预测AECOPD患者无创通气的结局。无创通气在治疗AECOPD所致呼吸衰竭中的价值已得到广泛认可。超声诊断的膈肌功能障碍与机械通气和撤机时间延长以及更高的死亡率相关。
