Cardiopulmonary MedicineCLINICAL PRACTICE

Functional evaluation of the diaphragm with a noninvasive test

Bruno Bordoni, DO, PhD; and Allan R. Escher, DO
Notes and Affiliations
Notes and Affiliations

Received: April 6, 2021

Accepted: May 25, 2021

Published: September 14, 2021

  • Bruno Bordoni, DO, PhD, 

    Foundation Don Carlo Gnocchi IRCCS, Department of Cardiology, Institute of Hospitalization and Care with Scientific, Milan, Italy

  • Allan R. Escher, DO, 

    Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

Abstract

Cardiac surgery with median sternotomy causes iatrogenic damage to the function of the diaphragm muscle that is both temporary and permanent. Myocardial infarction itself causes diaphragmatic genetic alterations, which lead the muscle to nonphysiological adaptation. The respiratory muscle area plays several roles in maintaining both physical and mental health, as well as in maximizing recovery after a cardiac event. The evaluation of the diaphragm is a fundamental step in the therapeutic process, including the use of instruments such as ultrasound, magnetic resonance imaging (MRI), and computed axial tomography (CT). This article reviews the neurophysiological relationships of the diaphragm muscle and the symptoms of diaphragmatic contractile dysfunction. The authors discuss a scientific basis for the use of a new noninstrumental diaphragmatic test in the hope of stimulating research.

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