Noninvasive Prediction of Twitch Transdiaphragmatic Pressure: Insights from Spirometry, Diaphragm Ultrasound, and Phrenic Nerve Stimulation Studies

Respiration; International Review of Thoracic Diseases
Jens SpiesshoeferMatthias Boentert

Abstract

Twitch transdiaphragmatic pressure (twPdi) following magnetic stimulation (MS) of the phrenic nerves is the gold standard for non-volitional assessment of diaphragm strength. Expiratory muscle function can be investigated using MS of the abdominal muscles and measurement of twitch gastric pressure (twPgas). To investigate whether twitch pressures following MS of the phrenic and lower thoracic nerve roots can be predicted noninvasively by diaphragm ultrasound parameters and volitional tests of respiratory muscle strength. Sixty-three healthy subjects underwent standard spirometry, measurement of maximum inspiratory (PImax) and expiratory pressure (PEmax), and diaphragm ultrasound. TwPdi following cervical MS of the phrenic nerve roots and twPgas after lower thoracic MS (twPgas-Thor) were measured using esophageal and gastric balloon catheters inserted transnasally. Using surface electrodes, compound muscle action potentials (CMAP) were simultaneously recorded from the diaphragm or obliquus abdominis muscles, respectively. Forced expiratory flow (FEF25-75) was significantly correlated with twPdi (r = 0.37; p = 0.003) and its components (twPgas and twitch esophageal pressure, twPes). Diaphragm excursion velocity during tidal breat...Continue Reading

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Citations

Dec 27, 2019·Current Opinion in Critical Care·Martin Dres, Alexandre Demoule
Dec 17, 2019·Neuromuscular Disorders : NMD·Carolin HenkeMatthias Boentert
May 14, 2020·Respiration; International Review of Thoracic Diseases·Jens SpiesshoeferMatthias Boentert
May 13, 2020·Respiration; International Review of Thoracic Diseases·Jens SpiesshoeferMatthias Boentert

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