Evaluation of Diaphragm in Chronic Obstructive Pulmonary Disease Patients by Ultrasound in Relation to Severity

Study Overview
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Brief Summary
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The study of the diaphragm is an important point in the assessment of COPD patients. Ultrasonographic evaluation of the diaphragm is considered a simple, non-invasive, available bedside technique. Ultrasonography can be used for evaluation of the site, structure, and motion of the diaphragm, assessment of excursion, and thickness. The aim of the study is ultrasonographic assessment of the diaphragm in COPD patients and its relation to disease severity

Detailed Description
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The study was conducted on eighty patients, forty COPD patients who were diagnosed and classified into four groups according as following: The first group: included 10 patients with a mild stage. The second group: included 10 patients with a moderate stage. The third group: included 10 patients with a severe stage. The fourth group: included 10 patients with a very severe stage. The study also included forty healthy individuals of the same age and sex as COPD patients. All participants gave their informed consent for inclusion before sharing in the study. Every person was submitted to: Full medical history, Clinical examination,Chest x-ray, spirometry and ultrasonographic assessment of diaphragm function (thickness and excursion)

Official Title
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Evaluation of Diaphragm in Chronic Obstructive Pulmonary Disease Patients Using Ultrasonography in Relation to Disease Severity in Fayoum University Hospital

Conditions
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Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Device: ultrasonography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Stable COPD patients aged more than 40 years who were diagnosed and classified into four groups of severity according to GOLD 2020. Age and sex-matched healthy controls Exclusion Criteria: • Patient with a known neuromuscular disorder. Patient with known anatomical malformation of the diaphragm. Post abdominal or thoracic surgery.

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 40 COPD patients<br>all participants were subjected to : history - clinical examination - spirometry - ultrasound evaluation of diaphragmatic function | Device: ultrasonography<br>* ultrasound assessment of diaphragm function<br>|
| 40 healthy individuals<br>all participants were subjected to : history - clinical examination - spirometry - ultrasound evaluation of diaphragmatic function | Device: ultrasonography<br>* ultrasound assessment of diaphragm function<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| measure diaphragmatic thickness by ultrasound | measure diaphragmatic thickness at total lung capacity and residual volume in millimetres to calculate diaphragm thickness fraction | 1 year study | 
| measure diaphragm excursion by ultrasound | measure diaphragm excursion in centimetres at zone of apposition | 1 year study | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| spirometry assessment | value of forced expiratory volume in first second is assessed as a percentage of normal by spirometry to assess disease severity | 1 year study | 
| questionnaires | ( modified medical research council and chronic obstructive pulmonary disease assessment test) to detect severity of the disease | 1 year study | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ultrasonography, diaphragm, COPD, Fayoum