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Diaphragmatic Mobility Measurement in Patients with Burn Injury on Chest and Neck
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A5859 - Diaphragmatic Mobility Measurement in Patients with Burn Injury on Chest and Neck
Author Block: S. Lee1, S. Joo2; 1Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Bucheon-si, Gyeonggi-do, Korea, Republic of, 2Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea, Republic of.
RATIONALE Lung complications caused by large surface burns occurring during a fire remains a serious problem. Evaluating the mobility of the diaphragm is important for understanding and possible diagnostic alterations in the muscles, which can be compromised in several ways due to central or peripheral dysfunction, muscular disease and thoracic or abdominal diseases. The fluoroscopy is the most accurate method for assessing the diaphragm muscle because it provides dynamic images of the diaphragm and direct visualization of diaphragmatic movements in real time. There are no studies confirming the effect of diaphragmatic mobility on chest and neck burn injury, the aim of this study was to evaluate the diaphragmatic mobility in patients with large chest and neck burn injury. METHODS Ten patients with chest and neck burn injury were included. The burn surface area of chest and neck are more than 50% of the anterior or posterior trunk areas. Spirometer was done to evaluate pulmonary function. Pulmonary function tests including forced vital capacity (FVC), 1 second forced expiratory volume (FEV1), forced expiratory flow rate between 25 and 75% of the FVC (FEF 25-75), FEV1/FVC ratio and peak expiratory flow (PEF). Maximum voluntary ventilation (MVV) and respiratory muscles strength (maximal expiratory pressure, MEP; maximal inspiratory pressure, MIP) were measured by mouth pressure-meter in sitting position. Values for FVC, FEV1, FEF 25-75, MIP and MEP are expressed as percent of predicted values. Values of MVV and PEF are expressed by numerical value. Diaphragmatic mobility was measured by calculating the distance between the diaphragmatic dome in expiration and inspiration for the right and left hemidiaphragms by fluoroscopy. RESULTS The present study investigated 10 patients with airway obstruction mildly. The values of FVC, FEV1, FEF25-75, MIP and MEP are 76.5%, 75.2%, 69.1%, 68.4% and 61.8% of predicted values. The values of MVV and PEF are 68.85 L/min and 6.68 L/sec. The mean values of diaphragmatic mobility in patients with chest and neck burns were 44.00 mm. CONCLUSION This study demonstrated that diaphragmatic mobility was decreased in patients with chest and neck burn injury. A reduction in diaphragmatic mobility in patients with burn has been associated with a decline in pulmonary function parameters.
Author Block: S. Lee1, S. Joo2; 1Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Bucheon-si, Gyeonggi-do, Korea, Republic of, 2Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea, Republic of.
RATIONALE Lung complications caused by large surface burns occurring during a fire remains a serious problem. Evaluating the mobility of the diaphragm is important for understanding and possible diagnostic alterations in the muscles, which can be compromised in several ways due to central or peripheral dysfunction, muscular disease and thoracic or abdominal diseases. The fluoroscopy is the most accurate method for assessing the diaphragm muscle because it provides dynamic images of the diaphragm and direct visualization of diaphragmatic movements in real time. There are no studies confirming the effect of diaphragmatic mobility on chest and neck burn injury, the aim of this study was to evaluate the diaphragmatic mobility in patients with large chest and neck burn injury. METHODS Ten patients with chest and neck burn injury were included. The burn surface area of chest and neck are more than 50% of the anterior or posterior trunk areas. Spirometer was done to evaluate pulmonary function. Pulmonary function tests including forced vital capacity (FVC), 1 second forced expiratory volume (FEV1), forced expiratory flow rate between 25 and 75% of the FVC (FEF 25-75), FEV1/FVC ratio and peak expiratory flow (PEF). Maximum voluntary ventilation (MVV) and respiratory muscles strength (maximal expiratory pressure, MEP; maximal inspiratory pressure, MIP) were measured by mouth pressure-meter in sitting position. Values for FVC, FEV1, FEF 25-75, MIP and MEP are expressed as percent of predicted values. Values of MVV and PEF are expressed by numerical value. Diaphragmatic mobility was measured by calculating the distance between the diaphragmatic dome in expiration and inspiration for the right and left hemidiaphragms by fluoroscopy. RESULTS The present study investigated 10 patients with airway obstruction mildly. The values of FVC, FEV1, FEF25-75, MIP and MEP are 76.5%, 75.2%, 69.1%, 68.4% and 61.8% of predicted values. The values of MVV and PEF are 68.85 L/min and 6.68 L/sec. The mean values of diaphragmatic mobility in patients with chest and neck burns were 44.00 mm. CONCLUSION This study demonstrated that diaphragmatic mobility was decreased in patients with chest and neck burn injury. A reduction in diaphragmatic mobility in patients with burn has been associated with a decline in pulmonary function parameters.
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