Diaphragm ultrasound in patients with interstitial lung disease

A diverse collection of pulmonary conditions known as interstitial lung diseases (ILDs) are presented by dyspnea, reductions in lung volume, gas exchange, and exercise tolerance, as well as decreased survival and quality of life. Even though those traits have been linked to parenchymal involvement, the idea has recently come under scrutiny due to the discovery that patients with ILD also have decreased peripheral muscle performance. The purpose of this study was to assess the viability of diaphragm ultrasound imaging in interstitial lung disease (ILD). This prospective cross-sectional study will include 50 subjects with ILD and a control group of 20 healthy volunteers who are similar to the patients for age, gender, body mass index, and smoking status. from those came to Chest department in Benha University Hospital, at the period of February 2023 to February 2024. All patients had written concent , Full history taking and clinical examination, HRCT chest, PFT, oxygen saturation by pulse oximetry, Serological analysis for CTD, Ultrasound imaging of the diaphragm. Results: The study population consisted of 50 patients had ILD due to different causes and 20 healthy control persons. The mean age (±SD) of the studied group was 59.11(±7.23) years. 60.0% of them were females. There were no significant differences between cases and control according to their age and sex (P˃ 0.05). There were highly significant differences between cases and control regarding to their diaphragmatic measurements and mobility (P = 0.000). Diaphragmatic inspiratory thickness was significantly lower among ILD patients (median (range) = 0.88 (0.35-1.60) mm) than control (median (range)= 2.0 (1.50-2.70) mm). Diaphragmatic expiratory thickness was significantly lower among ILD patients (mean±SD= 0.80 ± 0.30 mm) than control (mean±SD=1.91 ± 0.35 mm). Thickness fraction was significantly lower among ILD patients (median (range) = 4.25 (1.01-100.0) mm) than control (median (range)= 6.67 (4.10-21.0) mm). Thoracic excursion during deep breath was significantly lower among ILD patients (median (range) = 5.05 (1.96-7.00) cm) than control (median (range)= 8.00 (6.00-10.00) cm ). 80 % of ILD patients had reduced mobility while 100% of control had normal mobility. Conclusion: One accurate and non-invasive method for evaluating diaphragmatic function is ultrasound. Patients with ILD have decreased diaphragmatic inspiratory thickness, expiratory thickness, thickness fraction, mobility, and excursion when compared to healthy controls.