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The study is designed to characterize the changes in diaphragm function after lung transplantation.
Diaphragm dysfunction (DD) is a well-known complication after lung transplantation. Patients with an injured and dysfunctional diaphragm have greater difficulty weaning from mechanical ventilation post-transplant - they become too weak to breathe. However, little is known about the pre-transplant predictive factors associated with diaphragm dysfunction . We have developed a new technique employing beside ultrasound to measure diaphragm thickness. This allows us to observe changes in diaphragm muscle structure and function.
The goal of the study is to determine whether pre-transplant diaphragm thickness and function are associated with diaphragmatic dysfunction after lung transplantation. This will help us to confirm the best way to avoid diaphragm injury and to understanding the meaning of diaphragm ultrasound images.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ultrasound | Diagnostic Test | Sonographic measurements (diaphragm, abdominal muscle, and quadriceps thickness) will be acquired when listed for lung transplantation. Sonographic measurements will be recorded on a daily basis for up to 1 week after transplantation (while the patient remains intubated). | ||
| Respiratory function measurements | Diagnostic Test | Maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP) will be acquired after listing for lung transplantation. After transplant, MIP will be recorded once patients are eligible for a trial of spontaneous breathing and weekly thereafter. MEP will also be recorded at ICU discharge. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of diaphragm dysfunction at the first spontaneous breathing trial and at ICU discharge after lung transplantation | Diaphragm ultrasound will be used to visualize diaphragm dysfunction (maximal thickening fraction <20%) | First spontaneous breathing trial, an average of 1 to 7 days |
| Measure | Description | Time Frame |
|---|---|---|
| Pre-transplant diaphragm thickness and function compared to post-transplant diaphragm dysfunction | Diaphragm thickness and function documented on ultrasound will be assessed | 1 day |
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Inclusion Criteria:
Exclusion Criteria:
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We plan to enroll a total of 100 patients who were listed and will benefit from lung transplant
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| Name | Affiliation | Role |
|---|---|---|
| Ewan Goligher, MD, PhD | UHN Toronto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Toronto General Hospital | Toronto | Canada |
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| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D014463 | Ultrasonography |
| ID | Term |
|---|---|
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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