• Dinçer Yegin, Alten Oskay, Tülay Oskay, Selcan Enver Dinç, Hande Şenol, Mert Özen, Vefa Çakmak, Murat Seyit, Atakan Yilmaz, and İbrahim Türkçüer.
• Department of Emergency Medicine, Ardahan State Hospital, Ardahan, Turkiye.
• Turk J Med Sci. 2023 Aug 1; 53 (4): 100110111001-1011.

BackgroundThe respiratory muscles of patients with chronic obstructive pulmonary disease (COPD) exhibit structural and functional changes that can be evaluated and monitored by ultrasonography.MethodsThis single-center, prospective study was conducted in the emergency department (ED) of a tertiary care hospital over an eight-month period (September 2020-May 2021). Diaphragmatic excursions, end-expiratory thickness, and thickening fractions, as well as right and left intercostal muscle thicknesses, of all adult subjects manifesting COPD exacerbation, were assessed. The data were analyzed regarding ward/intensive care unit (ICU) hospitalization or discharge from the ED, mortality, and readmission within 15 days.ResultsSixty-three subjects were recruited for the study. Diaphragmatic excursion, end-expiratory diaphragmatic thickness, and intercostal muscle thickness measurements were significantly different between the ward, ICU, and discharge groups (p < 0.001) but lower in the deceased subjects (all p < 0.05). The diaphragmatic excursion value of 3.25 cm was the threshold value measured for distinguishing discharge from ED, and 1.82 cm was measured for admission to the ICU, both with 100% sensitivity and selectivity (AUC = 1).DiscussionDiaphragmatic excursion, diaphragmatic end-expiratory thickness, and right and left intercostal muscle thicknesses vary in the prognosis of subjects presenting with COPD exacerbation.

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