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An evaluation of diaphragmatic movement by M-mode sonography as a predictor of pulmonary dysfunction after upper abdominal surgery

DC Field Value Language
dc.contributor.author고신옥-
dc.contributor.author나성원-
dc.contributor.author라세희-
dc.contributor.author신서경-
dc.contributor.author최진섭-
dc.date.accessioned2015-04-23T16:37:53Z-
dc.date.available2015-04-23T16:37:53Z-
dc.date.issued2010-
dc.identifier.issn0003-2999-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/100935-
dc.description.abstractBACKGROUND: Diaphragmatic dysfunction is a major factor in the etiology of postoperative pulmonary complications after upper abdominal surgery. M-mode ultrasonography is now an accepted qualitative method of assessing diaphragmatic motion in normal and pathological conditions. In this study, we evaluated whether diaphragmatic inspiratory amplitude (DIA) as measured by M-mode sonography can be a predictor of pulmonary dysfunction. METHODS: A prospective, single-center, single-unit, observational study was performed in 35 ASA physical status I and II nonsmoking patients undergoing open liver lobectomy. Diaphragmatic movements were assessed by M-mode sonography after a pulmonary function test preoperatively and on postoperative days (PODs) 1, 2, and 7. We measured the DIA (cm) during quiet, deep, and sniff breathing. RESULTS: After liver lobectomy, DIA during deep breathing and vital capacity (VC) showed significant reductions of 60% from their preoperative values on PODs 1 and 2 (P < 0.001). By POD 7, the variables recovered significantly, by 30% from the values on PODs 1 and 2 (P < 0.001). During deep breathing, DIA showed a significant correlation with VC (r = 0.839, P < 0.0001). The best cutoff values of DIA for detecting 30% and 50% decreases of VC from preoperative values, calculated by receiver operating characteristic analysis, were 3.61 and 2.41 cm, with sensitivity of 94% and 81% and specificity of 76% and 91%, respectively (P = 0.0001). Two patients showed postoperative diaphragmatic paralysis but did not complain of respiratory distress symptoms or need supplemental oxygen after being transferred to the general ward. CONCLUSIONS: DIA using M-mode sonography showed a linear correlation with VC measured by spirometry throughout the postoperative period. We conclude that using the M-mode sonographic technique at the bedside can be a practical way to investigate postoperative diaphragmatic dysfunction, and may also be an effective bedside screening method for diaphragmatic paralysis.-
dc.description.statementOfResponsibilityopen-
dc.format.extent1349~1354-
dc.relation.isPartOfANESTHESIA AND ANALGESIA-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAbdomen/surgery*-
dc.subject.MESHAdolescent-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAnalgesia, Patient-Controlled-
dc.subject.MESHAnesthesia, General-
dc.subject.MESHDiaphragm/diagnostic imaging*-
dc.subject.MESHDiaphragm/physiopathology*-
dc.subject.MESHDigestive System Surgical Procedures-
dc.subject.MESHEchocardiography*-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHLiver/surgery-
dc.subject.MESHLung Diseases/etiology*-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPain Measurement-
dc.subject.MESHPain, Postoperative/diagnosis-
dc.subject.MESHPain, Postoperative/drug therapy-
dc.subject.MESHPostoperative Complications/etiology*-
dc.subject.MESHPredictive Value of Tests-
dc.subject.MESHPrognosis-
dc.subject.MESHProspective Studies-
dc.subject.MESHROC Curve-
dc.subject.MESHRespiratory Function Tests-
dc.subject.MESHRespiratory Paralysis/etiology-
dc.subject.MESHSpirometry-
dc.subject.MESHVital Capacity/physiology-
dc.subject.MESHYoung Adult-
dc.titleAn evaluation of diaphragmatic movement by M-mode sonography as a predictor of pulmonary dysfunction after upper abdominal surgery-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Anesthesiology (마취통증의학)-
dc.contributor.googleauthorSoo Hwan Kim-
dc.contributor.googleauthorSungwon Na-
dc.contributor.googleauthorJin-Sub Choi-
dc.contributor.googleauthorSe Hee Na-
dc.contributor.googleauthorSeokyung Shin-
dc.contributor.googleauthorShin Ok Koh-
dc.identifier.doi10.1213/ANE.0b013e3181d5e4d8-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA00126-
dc.contributor.localIdA01232-
dc.contributor.localIdA01317-
dc.contributor.localIdA02109-
dc.contributor.localIdA04199-
dc.relation.journalcodeJ00144-
dc.identifier.eissn1526-7598-
dc.identifier.pmid20418298-
dc.identifier.urlhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000539-201005000-00018&LSLINK=80&D=ovft-
dc.contributor.alternativeNameKoh, Shin Ok-
dc.contributor.alternativeNameNa, Sung Won-
dc.contributor.alternativeNameNa, Se Hee-
dc.contributor.alternativeNameShin, Seo Kyung-
dc.contributor.alternativeNameChoi, Jin Sub-
dc.contributor.affiliatedAuthorKoh, Shin Ok-
dc.contributor.affiliatedAuthorNa, Sung Won-
dc.contributor.affiliatedAuthorNa, Se Hee-
dc.contributor.affiliatedAuthorShin, Seo Kyung-
dc.contributor.affiliatedAuthorChoi, Jin Sub-
dc.citation.volume110-
dc.citation.number5-
dc.citation.startPage1349-
dc.citation.endPage1354-
dc.identifier.bibliographicCitationANESTHESIA AND ANALGESIA, Vol.110(5) : 1349-1354, 2010-
dc.identifier.rimsid54066-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers

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