• BMC anesthesiology · Nov 2021

    Observational Study

    Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization.

    • Jiaxin Lang, Yuchao Liu, Yuelun Zhang, Yuguang Huang, and Jie Yi.
    • Department of Anesthesiology, Chinese Academy of Medical Science, Peking Union Medical College Hospital, No 1, Shuaifuyan, Dongcheng district, Beijing, 100730, China.
    • BMC Anesthesiol. 2021 Nov 19; 21 (1): 287.

    BackgroundThis study sought to evaluate the diagnostic accuracy of peri-operative diaphragm ultrasound in assessing post-operative residual curarization (PORC).MethodsPatients undergoing non-thoracic and non-abdominal surgery under general anaesthesia were enrolled from July 2019 to October 2019 at Peking Union Medical College Hospital. A train-of-four ratio (TOFr) lower than 0.9 was considered as the gold standard for PORC. Diaphragm ultrasound parameters included diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) during quiet breathing (QB) and deep breathing (DB). The diaphragm excursion fraction (DEF) was calculated as the DE-QB divided by the DE-DB. The diaphragm excursion difference (DED) was defined as DE-DB minus DE-QB. Receiver operating characteristic curve analysis was used to determine the cut-off values of ultrasound parameters for the prediction of PORC.ResultsIn total, 75 patients were included, with a PORC incidence of 54.6%. The DE-DB and DED were positively correlated with the TOFr, while the DEF was negatively correlated with the TOFr. The DE-DB cut-off value for predicting PORC was 3.88 cm, with a sensitivity of 85.4% (95% confidence interval [CI]: 70.1-93.9%), specificity of 64.7% (95% CI: 46.4-79.7%), positive likelihood ratio of 2.42 (95% CI 1.5-3.9), and negative likelihood ratio of 0.23 (95% CI: 0.1-0.5). The DED cut-off value was 1.5 cm, with a specificity of 94.2% (95% CI: 80.3-99.3%), sensitivity of 63.4% (95% CI: 46.9-77.9%), positive likelihood ratio of 10.78 (95% CI: 2.8-42.2), and negative likelihood ratio of 0.39 (95% CI: 0.3-0.6).ConclusionsPeri-operative diaphragm ultrasound may be an additional method aiding the recognition of PORC, with DED having high specificity.© 2021. The Author(s).

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…