Citation Information :
Chandrakumar AK, Baby J, Xavier ES, Valsalan P, Puthanveettil R. Correlation Between Ultrasonographic Evaluation of Diaphragm Excursion, Thickness and Spirometry in COPD patients: A Case-Control Study. Indian J Respir Care 2023; 12 (1):33-37.
Background: Weakness of the diaphragm is associated with dyspnea and exercise intolerance and affects survival in chronic obstructive pulmonary disease (COPD) patients. The present study aimed to evaluate diaphragm excursion, and thickness using ultrasonography (USG) and spirometry values in patients with COPD, correlate these values and compare them with healthy controls.
Methodology: This case-control study was conducted in a tertiary care center in South India for 1 year. A total of 70 patients with COPD and 70 healthy controls were recruited. Data were collected and statistically analyzed.
Results: The absolute value of forced expiratory volume 1 (FEV1) and the percentage of predicted FEV1, forced vital capacity (FVC), and FEV1/FVC was significantly lower in COPD patients (p < 0.0001). Diaphragm excursion at normal inspiration, deep inspiration, and while sniffing was significantly lower in COPD patients (p < 0.01). Diaphragm thickness at end-inspiration, end-expiration, and diaphragm thickness fraction (DTF) was significantly lower in COPD patients compared to normal healthy subjects (p < 0.01).
Conclusion: A mild positive correlation was found between diaphragm excursion at normal inspiration and FEV1. There was a strong correlation between FEV1 and diaphragm excursion during deep inspiration and sniffing. A linear equation was developed to calculate FEV1. FEV1 = 2.99 – (0.042 × age) + (0.224 × deep inspiration) + (0.015 × sniffing). This could predict risks for any major surgeries, decide on treatment options for COPD patients, and can be used for prognosis and follow-up while the patient is on inhaler therapy.
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