Abstract
Purpose
The standard conditions of spirometry (i.e., wearing a noseclip and breathing through a mouthpiece and a pneumotachograph) are likely to alter the ventilatory pattern. We used “time-motion” mode (M-mode) sonography to assess the changes in diaphragm kinetics induced by spirometry dunng quiet breathing.
Methods
An M-mode sonographic study of the nght diaphragm was performed before and dunng standard spirometry in eight patients without respiratory disease (age 34 to 68 yr).
Results
During spirometry, the diaphragm inspiratory amplitude (DIA) increased from 1.34 ± 0.18 cm to 1.80 ± 0.18 cm (P = 0.007), whereas the diaphragmatic mspiratory time (T1 diaph) increased from 1.27 ± 0.15 to 1.53 ± 0.23 sec, (P = 0.015), without change in diaphragmatic total time interval (Ttot diaph). Therefore, the diaphragm duty cycle (T1 diaph /Ttot diaph) increased from 38% ± 1% to 44% ± 4% (P = 0.023). The diaphragm inspiratory (DIV) and expiratory (DEV) motion velocity increased (P = 0.007).
Conclusion
M-mode sonography enabled us to demonstrate that the weanng of a nose clip and breathing through a mouthpiece and a pneumotachograph induce measurable changes in diaphragm kinetics.
Résumé
Objectif
Les conditions de la spirométne standard (c.-à-d. le port du pince-nez et la respiration à travers un embout buccal et un pneumotacographe) sont susceptibles d’altérer la morphologie de la ventilation. Nous avons utilisé le mode «temps-amplitude» (mode M) de la sonographie pour évaluer les changements de la cinétique diaphragmatique provoqués par la spirométne pendant la respiration de repos.
Résultats
Pendant la spirométne, l’amplitude mspiratoire diaphragmatique augmentait de 1, 34 ± 0, 18 à 1, 80 ± 0, 18 cm (P = 0, 007), alors que le temps diaphragmatique mspiratoire (T1 diaph) augmentait de 1, 27 ± 0, 15 à 1, 53 ± 0, 23 sec (P = 0, 015), sans changement du temps diaphragmatique total (Ttot diaph). Par conséquent, le temps de l’activité diaphragmatique (T1 diaph/Ttot diaph) augmentait de 38 ± 1 % à 44 ± 4% (P = 0, 023). La vélocité de l’amplitude mspiratoire et expiratoire augmentait (P = 0, 007).
Conclusion
La sonographie en mode M nous a permis de démontrer que le port du pince-nez et la respiration à travers un embout buccal et un pneumotacographe provoquent des changements tangibles de la cinétique diaphragmatique.
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Abbreviations
- M:
-
mode sonography, time-motion mode sonography
- DIA:
-
diaphragm inspiratory amplitude
- T1 :
-
diaph, diaphragm inspiratory time
- TE :
-
diaph, diaphragm expiratory time
- DIV:
-
diaphragm inspiratory motion mean velocity
- DEV:
-
diaphragm expiratory motion mean velocity
- Ttot :
-
diaph, total time of diaphragmatic cycle
- T1/Ttot :
-
diaph, the diaphragmatic inspiratory ratio
- DMT:
-
diaphragm motion time
- DRT:
-
diaphragm resting time
- VT :
-
tidal volume
- T1 :
-
inspiratory time
- TE :
-
expiratory time
- VT/TI :
-
mean inspiratory flow
- Ttot :
-
total time
- TI/Ttot :
-
inspiratory duty cycle
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Ayoub, J., Cohendy, R., Dauzat, M. et al. Non-invasive quantification of diaphragm kinetics using m-mode sonography. Can J Anaesth 44, 739–744 (1997). https://doi.org/10.1007/BF03013389
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DOI: https://doi.org/10.1007/BF03013389