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Master Thesis

Prévalence, impact et réversibilité de la dysfonction diaphragmatique aiguë dans la détresse respiratoire aiguë mesurée par échographie diaphragmatique

Abstract : Introduction: Acute diaphragmatic dysfunction (DD+) is frequent in ICU and associated with a poor prognosis with worsened morbi-mortality. In our monocentric study we aimed to describe the prevalence, the early morbi mortality and the reversibility of DD+ in critically ill patients presenting with acute respiratory failure. We studied 3 groups of patients: hypercapnic COPD decompensation, acute hypoxemic infectious pneumonia and acute pulmonary oedema.
Methods: From april to october 2019, all the patients hospitalized in ICU in the CHU of Nice for acture respiratory failure under NIV of high flow oxygen therapy were included. Presence of DD+ was defined by the best thickening fraction (Tdfi) < 20%. The ultrasound was repeated at day 2, at ICU discharge and if a new acute respiratory failure occurred. If DD+ was present at admission, an ultrasound was planned 14 days after hospital discharge.
Results: We included 21 patients. The overall prevalence of DD+ was 33%. It was 33% for COPD decompensation, 60% for hypoxemic pneumonias and 12,5% for acute pulmonary oedema. The only factor associated with DD+ at admission was the CRP (181 mg/L VS 75 mg/L, p < 0,01). We did not report any difference in early morbi-mortality. We reported a reversibility in 86% of cases.
Conclusion: DD+ is significant in critically ill patients and is associated with higher severity. It is early reversible in most cases. It is seems similar to the other organ dysfunctions reported in critically ill patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02986951
Contributor : Bibliothèque Universitaire de Médecine Nice <>
Submitted on : Tuesday, November 3, 2020 - 1:47:27 PM
Last modification on : Thursday, February 25, 2021 - 3:10:47 AM

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Julia Beatini. Prévalence, impact et réversibilité de la dysfonction diaphragmatique aiguë dans la détresse respiratoire aiguë mesurée par échographie diaphragmatique. Médecine humaine et pathologie. 2019. ⟨dumas-02986951⟩

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