Asian Cardiovasc Thorac Ann 2003;11:289-292
© 2003 Asia Publishing EXchange Ltd
Ultrasonography and Lung Mechanics Can Diagnose Diaphragmatic Paralysis Quickly
Takahiro Manabe, MD,
Masahide Ohtsuka, MD,
Yutaka Usuda, MD,
Kiyotaka Imoto, MD,
Michio Tobe, MD,
Yoshinori Takanashi, MD
First Department of Surgery, Yokohama City University School of Medicine, Yokohama, Japan
For reprint information contact: Takahiro Manabe, MD Tel: 81 45 787 2645 Fax: 81 45 786 0226 email: manaberu{at}aol.com 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Japan.
Diaphragmatic paralysis after cardiovascular surgery requires early diagnosis prior to extubation. The effectiveness of ultrasonography and a lung mechanics assessment was evaluated. Paralysis of the diaphragm was diagnosed when the diaphragm failed to move or moved in a cephalad direction during inspiration. It was diagnosed in 3 of 40 patients (7.5%) who underwent cardiovascular surgery from 1998 to 1999. Patients were extubated when all parameters met the extubation criteria, irrespective of the presence or absence of diaphragmatic paralysis. One patient required prolonged assisted ventilation and died from mediastinitis on the 35th postoperative day. The other 2 patients required assisted ventilation for an additional 1–3 days. Ultrasonography and a lung mechanics assessment are effective tools for the early diagnosis of diaphragmatic paralysis and assessment of respiratory function after cardiovascular surgery.
Copyright © 2003 by the Asia Publishing EXchange Ltd.
