Chest Ultrasonography in Chronic Obstructive Pulmonary Disease Across Stability and Exacerbation

Abstract

<bold>Introduction:</bold> Chest ultrasonography (CU) has emerged as a promising tool in the assessment of Chronic Obstructive Pulmonary Disease (COPD), offering real-time visualization of lung and diaphragmatic movements. <bold>Objective:</bold> To assess the value of CU in stable and exacerbating COPD patients, specifically examining diaphragmatic measurements and their relationship with spirometry and other clinical factors. <bold>Methods:</bold> In a prospective comparative study conducted at our pulmonology department from September to December 2023, we enrolled 100 COPD patients. This cohort was divided into two groups: 60 stable COPD patients (G1) and 40 patients experiencing exacerbations (G2). Diaphragmatic excursion (DE), thickness (DT), and thickening fraction (TF) were measured as indicators of diaphragmatic function, with TF calculated as (thickness at end inspiration - thickness at end expiration) divided by thickness at end expiration. <bold>Results:</bold> All participants were male, with a mean age of 62.78 ± 7 years in G1 and 63.72 ± 6.5 years in G2. Both groups showed similar age distribution and comorbidities. In G2, multiple A-lines (more than 3) and B-lines were more prevalent compared to G1. DT and DE exhibited a significant negative correlation with body mass index (r=-0.376; p=0.01) and the BORG scale (r=-0.465; p=0.002), and a positive correlation with Vital Capacity (r=0.341; p<0.001), Forced Expiratory Volume in the first second (r=0.321; P<10^-3), and poor therapeutic compliance (r=0.369; P<10^-3) across both groups. Notably, in G2, TF showed significant associations with acute hypercapnic respiratory failure (p=0.001) and mortality (p=0.01). <bold>Conclusion:</bold> Our study underscores chest ultrasound's role in managing COPD.