Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization

Abstract Background This study sought to evaluate the diagnostic accuracy of peri-operative diaphragm ultrasound in assessing post-operative residual curarization (PORC). Methods Patients undergoing non-thoracic and non-abdominal surgery under general anaesthesia were enrolled from July 2019 to Octo...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jiaxin Lang, Yuchao Liu, Yuelun Zhang, Yuguang Huang, Jie Yi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Diaphragm ultrasound Diagnostic test Neuromuscular monitor Train-of-four Post-operative residual Curarization Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/a976e0bd9f5c49fcbbd6fb2b4127c755
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:a976e0bd9f5c49fcbbd6fb2b4127c755
record_format	dspace
spelling	oai:doaj.org-article:a976e0bd9f5c49fcbbd6fb2b4127c7552021-11-21T12:08:00ZPeri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization10.1186/s12871-021-01506-31471-2253https://doaj.org/article/a976e0bd9f5c49fcbbd6fb2b4127c7552021-11-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01506-3https://doaj.org/toc/1471-2253Abstract Background This study sought to evaluate the diagnostic accuracy of peri-operative diaphragm ultrasound in assessing post-operative residual curarization (PORC). Methods Patients undergoing non-thoracic and non-abdominal surgery under general anaesthesia were enrolled from July 2019 to October 2019 at Peking Union Medical College Hospital. A train-of-four ratio (TOFr) lower than 0.9 was considered as the gold standard for PORC. Diaphragm ultrasound parameters included diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) during quiet breathing (QB) and deep breathing (DB). The diaphragm excursion fraction (DEF) was calculated as the DE-QB divided by the DE-DB. The diaphragm excursion difference (DED) was defined as DE-DB minus DE-QB. Receiver operating characteristic curve analysis was used to determine the cut-off values of ultrasound parameters for the prediction of PORC. Results In total, 75 patients were included, with a PORC incidence of 54.6%. The DE-DB and DED were positively correlated with the TOFr, while the DEF was negatively correlated with the TOFr. The DE-DB cut-off value for predicting PORC was 3.88 cm, with a sensitivity of 85.4% (95% confidence interval [CI]: 70.1–93.9%), specificity of 64.7% (95% CI: 46.4–79.7%), positive likelihood ratio of 2.42 (95% CI 1.5–3.9), and negative likelihood ratio of 0.23 (95% CI: 0.1–0.5). The DED cut-off value was 1.5 cm, with a specificity of 94.2% (95% CI: 80.3–99.3%), sensitivity of 63.4% (95% CI: 46.9–77.9%), positive likelihood ratio of 10.78 (95% CI: 2.8–42.2), and negative likelihood ratio of 0.39 (95% CI: 0.3–0.6). Conclusions Peri-operative diaphragm ultrasound may be an additional method aiding the recognition of PORC, with DED having high specificity.Jiaxin LangYuchao LiuYuelun ZhangYuguang HuangJie YiBMCarticleDiaphragm ultrasoundDiagnostic testNeuromuscular monitorTrain-of-fourPost-operative residual CurarizationAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diaphragm ultrasound Diagnostic test Neuromuscular monitor Train-of-four Post-operative residual Curarization Anesthesiology RD78.3-87.3
spellingShingle	Diaphragm ultrasound Diagnostic test Neuromuscular monitor Train-of-four Post-operative residual Curarization Anesthesiology RD78.3-87.3 Jiaxin Lang Yuchao Liu Yuelun Zhang Yuguang Huang Jie Yi Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization
description	Abstract Background This study sought to evaluate the diagnostic accuracy of peri-operative diaphragm ultrasound in assessing post-operative residual curarization (PORC). Methods Patients undergoing non-thoracic and non-abdominal surgery under general anaesthesia were enrolled from July 2019 to October 2019 at Peking Union Medical College Hospital. A train-of-four ratio (TOFr) lower than 0.9 was considered as the gold standard for PORC. Diaphragm ultrasound parameters included diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) during quiet breathing (QB) and deep breathing (DB). The diaphragm excursion fraction (DEF) was calculated as the DE-QB divided by the DE-DB. The diaphragm excursion difference (DED) was defined as DE-DB minus DE-QB. Receiver operating characteristic curve analysis was used to determine the cut-off values of ultrasound parameters for the prediction of PORC. Results In total, 75 patients were included, with a PORC incidence of 54.6%. The DE-DB and DED were positively correlated with the TOFr, while the DEF was negatively correlated with the TOFr. The DE-DB cut-off value for predicting PORC was 3.88 cm, with a sensitivity of 85.4% (95% confidence interval [CI]: 70.1–93.9%), specificity of 64.7% (95% CI: 46.4–79.7%), positive likelihood ratio of 2.42 (95% CI 1.5–3.9), and negative likelihood ratio of 0.23 (95% CI: 0.1–0.5). The DED cut-off value was 1.5 cm, with a specificity of 94.2% (95% CI: 80.3–99.3%), sensitivity of 63.4% (95% CI: 46.9–77.9%), positive likelihood ratio of 10.78 (95% CI: 2.8–42.2), and negative likelihood ratio of 0.39 (95% CI: 0.3–0.6). Conclusions Peri-operative diaphragm ultrasound may be an additional method aiding the recognition of PORC, with DED having high specificity.
format	article
author	Jiaxin Lang Yuchao Liu Yuelun Zhang Yuguang Huang Jie Yi
author_facet	Jiaxin Lang Yuchao Liu Yuelun Zhang Yuguang Huang Jie Yi
author_sort	Jiaxin Lang
title	Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization
title_short	Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization
title_full	Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization
title_fullStr	Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization
title_full_unstemmed	Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization
title_sort	peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization
publisher	BMC
publishDate	2021
url	https://doaj.org/article/a976e0bd9f5c49fcbbd6fb2b4127c755
work_keys_str_mv	AT jiaxinlang perioperativediaphragmultrasoundasanewmethodofrecognizingpostoperativeresidualcurarization AT yuchaoliu perioperativediaphragmultrasoundasanewmethodofrecognizingpostoperativeresidualcurarization AT yuelunzhang perioperativediaphragmultrasoundasanewmethodofrecognizingpostoperativeresidualcurarization AT yuguanghuang perioperativediaphragmultrasoundasanewmethodofrecognizingpostoperativeresidualcurarization AT jieyi perioperativediaphragmultrasoundasanewmethodofrecognizingpostoperativeresidualcurarization
_version_	1718419205036965888

Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization

Ejemplares similares