Association of Diaphragmatic ultrasound parameters with preoperative pulmonary function tests and postoperative respiratory complications in patients undergoing major abdominal surgeries

Authors: Aarti Agarwal, Shreya Khatri, Sanjay Dhiraaj, Hira lal, Rajneesh kumar Singh, Puneet Goyal

DOI: 10.18231/j.ijca.8558.1758876204

Keywords: Diaphragm ultrasound, Pulmonary Function tests , Postoperative pulmonary complications

Abstract: Objective: To determine whether diaphragmatic excursion, thickness and thickening fraction performed in the preoperative period correlate with preoperative pulmonary function test and respiratory reserve of the patients and postoperative pulmonary complications. Methods: It was prospective observational pilot study in 60 adult patients undergoing major abdominal surgery. Preoperative Pulmonary function test and Diaphragm ultrasound performed and parameters recorded and then surgery was conducted using standard GA protocol. Patients were divided into 2 groups Group A (extubated on table) and Group B (could not be extubated on OT table and required postoperative ventilatory support) and the patients were followed for 72 hours for development of any respiratory insufficiency. Results: Out of 60 patients included in analysis, 42 could be extubated on table (Group A) whereas 18 patients required ventilatory support (Group B). Patients who required postoperative ventilatory support had significantly lower values of various parameters of pulmonary function tests and Diaphragm ultrasound parameters in comparison to those patients who could be extubated. Conclusion: There is significant association between preoperative pulmonary function tests as well as diaphragm ultrasound parameters and requirement of postoperative ventilatory support in patients undergoing major abdominal surgery. Also diaphragm ultrasound parameters correlate well with preoperative pulmonary function tests in predicting requirement of postoperative ventilatory support.