Published in:
01-09-2020 | Imaging in Intensive Care Medicine
Diaphragmatic excursion tissue Doppler sonographic assessment
Published in: Intensive Care Medicine | Issue 9/2020
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Tissue Doppler sonographic assessment of diaphragmatic excursion kinetics is depicted in Fig. 1. At bedside, with patient in 30°-semi-recumbent position, using an ultrasound machine equipped with a sectorial (1.8–4.2 MHz) probe and a dedicated cardiac tissue Doppler application (Xario 200, Canon Medical System, Europe), on the right side, the transducer is positioned between midclavicular and anterior axillary lines, and medially, cranially, and dorsally oriented to find the hepatic veins confluence into inferior vena cava. With the ultrasound beam perpendicularly directed towards diaphragmatic line and the tissue Doppler application working, diaphragmatic image is optimized reducing gain and excluding high-frequency signals. Pulsed Doppler cursor with max amplitude sample box is perpendicularly positioned on diaphragmatic line to acquire its excursion. Thus, inspiratory and expiratory mean and peak velocity, acceleration (from diaphragmatic displacement onset to peak velocity), and excursion (velocity integral over time) are acquired.
Fig. 1
Tissue Doppler sonographic assessment of diaphragmatic excursion kinetics. a Shows the spectrum of inspiratory and expiratory diaphragmatic displacement velocity over time, whereas b depicts diaphragmatic excursion tissue Doppler parameters as follows: dark blue line, inspiratory velocity; light blue arrow, inspiratory peak velocity; area under inspiratory velocity curve, inspiratory displacement; green line, inspiratory acceleration; light blue line, expiratory velocity; white arrow, expiratory peak velocity; area under expiratory velocity curve, expiratory displacement; red line, expiratory acceleration
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