Relation between pulmonary function changes and diaphragmatic ultrasound in patients with idiopathic pulmonary fibrosis

Abstract

Background: IPF is a chronic disease with impaired diaphragmatic function. In the vast majority of patients, lung function gradually deteriorates until intractable respiratory failure occurs. Aim of work: To assess diaphragmatic ultrasound in IPF patients and its relation to functional parameters. Subjects and methods: This study used a case–control design and involved IPF patients who were either attending an outpatient clinic or admitted to a ward at Ain Shams University Hospitals and Abbassia Chest Hospital. Forty-five participants were included and split up into 3 groups: group A: 15 IPF cases suffering from hypoxia. Group B: 15 IPF patients without hypoxia or respiratory failure. Group C: 15 healthy participants as controls. Result: Groups A and B had considerably decreased diaphragm excursion (QB), thickness of diaphragm at the end of inspiration, diaphragm thickness fraction, and diaphragm thickness fraction % when compared to the control group. Patients' diaphragm excursion during deep breathing was significantly smaller in group A than it was in the controls. The diaphragm excursion (QB and DB), the thickness of the diaphragm at the end of inspiration, the thickness fraction, and the fraction % were positively associated with FVC, FEF 25–75, FEV1, 6MWT, the O2 sat before, the O2 sat after, and the O2 at RA, while they were negatively correlated with FEV1/FVC. There was no difference between groups in diaphragm thickness at the end of expiration. Conclusion: Diaphragmatic ultrasound parameters demonstrated strong correlations with pulmonary function parameters, 6-min walk test, and oxygen saturation levels.