Clinical Value Of Bedside Ultrasound In Evaluating The Effect Of Mechanical Ventilation On Diaphragm Function

Objective:To explore the clinical value of bedside ultrasound in evaluating the effect of mechanical ventilation on diaphragm function.Methods:From December 2018 to September 2019,patients who need mechanical ventilation(MV group)and patients without mechanical ventilation(NMV)to establish artificial airway in the Department of critical medicine of Jinjiang people’s hospital and the First Affiliated Hospital of Fujian Medical University were selected as the research objects.The basic data of the two groups were collected when they were enrolled,including sex,age,body mass index,smoking,acute physiology and chronic health score Ⅱ(APACHE Ⅱ),primary diseases and so on.At the beginning of the study,12 hours,1day,2 days,3 days,4 days,5 days,6 days and 7 days,all subjects were examined for diaphragm function by bedside ultrasound,and their right diaphragm activity,end inspiratory diameter thickness(TDI EI),end inspiratory diameter thickness(end inspiratory diameter)were measured,TDI EE)and displacement(DE),and tfdi were calculated.Where tfdi =(TDI EI-TDI EE)/ TDI EE * 100%.Results:1.There was no significant difference in gender,age,body mass index,smoking,drinking,primary disease and Apache Ⅱ score between the two groups(P < 0.05).2.There was no significant difference between MV group and NMV group(P > 0.05).There was no significant difference in the activity of right diaphragm in NMV group(P > 0.05),and there was significant difference in MV group(P < 0.05).There was no significant difference between the two groups(P > 0.05).At 1D,2D,3D,4D,5D,6D,7d,the activity of right diaphragm in MV group was lower than that in NMV group,the difference was statistically significant(P < 0.05).3.There was significant difference in the displacement of diaphragm in MV group(P <0.05),and there was no significant difference in the displacement of diaphragm in NMV group(P > 0.05).There was no significant difference in diaphragm displacement between MV group and NMV group at admission,12h(P > 0.05).At 1D,2D,3D,4D,5D,6D,7d,the displacement of diaphragm in MV group and NMV group was lower than that in NMV group,the difference was statistically significant(P < 0.05).4.There was significant difference in phrenic thickening fraction of MV group(P <0.05),and there was no significant difference in phrenic thickening fraction of NMV group(P > 0.05).There was no significant difference between MV group and NMV group at the time of admission and 12h(P > 0.05).At 1D,2D,3D,4D,5D,6D,7d,the phrenic thickening fraction of MV group was lower than that of NMV group,the difference was statistically significant(P < 0.05).Conclusion:One day after mechanical ventilation,obvious diaphragmatic dysfunction began to appear.Bedside ultrasound can evaluate the diaphragmatic function of patients with mechanical ventilation noninvasively,directly,cheaply and repeatedly,which can provide effective data reference for clinical intervention.