ArticleIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine2021
Ultrasonographic Assessment of Diaphragmatic Inspiratory Amplitude and Its Association with Postoperative Pulmonary Complications in Upper Abdominal Surgery: A Prospective, Longitudinal, Observational Study.
Article in Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06396767 (Diaphragmatic Inspiratory Amplitude Measured by Ultrasonography as a Prognosticator for Postoperative Pulmonary Complications After Cardiac Surgery), which is not on this map. Cited by 10 papers.
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Diaphragmatic Inspiratory Amplitude Measured by Ultrasonography as a Prognosticator for Postoperative Pulmonary Complications After Cardiac Surgery: a Prospective Observational Cohort Study
Who cites it
10 citing papers in PubMed, 13 citations in OpenAlex.
- Respiratory effects of rectus sheath block in patients undergoing major upper abdominal surgery: a randomized controlled trial.BMC anesthesiology · 2026Trial
- Preoperative inspiratory muscle training preserved diaphragmatic excursion after esophagectomy: a randomized-controlled trial.Esophagus : official journal of the Japan Esophageal Society · 2025Trial
- Inspiratory Muscle Training Before Esophagectomy Increases Diaphragmatic Excursion: A Randomized Controlled Trial.Annals of surgical oncology · 2024Trial
- Maximal inspiratory diaphragmatic ultrasound predicts postoperative pulmonary complications after upper abdominal surgery.Annals of intensive care · 2025Article
- Diaphragmatic ultrasound-derived MV×DE: a novel predictor of postextubation adverse respiratory events in general anesthesia patients (observational study).BMC pulmonary medicine · 2025Observational
- Diaphragmatic ultrasound: approach, emerging evidence, and future perspectives in non-ICU patients.Internal and emergency medicine · 2025Review
- Diaphragm excursion difference as an adjunct predictor marker of postoperative pulmonary complications in video-assisted thoracoscopic surgery: a prospective, observational study.Journal of thoracic disease · 2025Article
- Enhanced Surgical Recovery Nursing Program: A Multidisciplinary Approach to Optimize Postoperative Patient Recovery.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Article
- Ultrasonographic evaluation of diaphragmatic excursion changes after major laparoscopic surgeries in the Trendelenburg position under general anaesthesia: A prospective observational study.Indian journal of anaesthesia · 2023Article
- Role of perioperative diaphragmatic point-of-care ultrasound in assessing postoperative pulmonary complications in brachial plexus repair surgeries with preexisting hemidiaphragm paresis: A prospective observational study.Journal of anaesthesiology, clinical pharmacologyArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiaphragmatic dysfunction following upper abdominal surgery is less recognized due to a lack of diagnostic modality for bedside evaluation. We used point-of-care ultrasound to evaluate the diaphragmatic inspiratory amplitude (DIA) in upper abdominal surgery for cancer. Our primary hypothesis was DIA would be reduced in the immediate postoperative period in patients with postoperative pulmonary complications (PPCs). Our aim was to identify an optimal cutoff of DIA for the diagnosis of PPCs.
methodsWe conducted a prospective, observational study in patients aged 18-75 years undergoing elective, upper abdominal oncological surgeries under combined general and epidural anesthesia. Ultrasound evaluation of the diaphragm was done by measuring the DIA in the right and left hemidiaphragms during quiet and deep breathing on the day before surgery and postoperative days (PODs) 1, 2, and 3. Patients were followed up for PPCs until POD 7. The linear mixed-effects model examined the association between DIA and PPCs and other perioperative factors. Receiver-operating characteristics analysis was done to determine the optimal cutoff of DIA in diagnosing PPCs.
resultsDIA measured in the 162 patients showed a significant decrease in their absolute values postoperatively from its preoperative baseline measurement. This decrease in DIA was significantly associated with PPC [right hemidiaphragm,
conclusionFollowing upper abdominal surgery, the DIA is decreased and associated with PPCs. DIA of left hemidiaphragm less than 1.3 cm during quiet breathing and 1.6 cm during deep breathing has a sensitivity of 77 and 75%, respectively, in diagnosing PPCs following upper abdominal surgery. HOW TO CITE THIS ARTICLE: Vanamail PV, Balakrishnan K, Prahlad S, Chockalingam P, Dash R, Soundararajan DK. Ultrasonographic Assessment of Diaphragmatic Inspiratory Amplitude and Its Association with Postoperative Pulmonary Complications in Upper Abdominal Surgery: A Prospective, Longitudinal, Observational Study. Indian J Crit Care Med 2021;25(9):1031-1039.
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