Observational studyCanadian journal of anaesthesia = Journal canadien d'anesthesie2023
Persistent diaphragm dysfunction after cardiac surgery is associated with adverse respiratory outcomes: a prospective observational ultrasound study.
Observational study in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 16 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Incidence of Postoperative Persistent Diaphragmatic Dysfunctions in Cardiac Surgery
Diaphragmatic Inspiratory Amplitude Measured by Ultrasonography as a Prognosticator for Postoperative Pulmonary Complications After Cardiac Surgery: a Prospective Observational Cohort Study
Who cites it
16 citing papers in PubMed, 17 citations in OpenAlex.
- Peri-operative rehabilitation in patients undergoing elective cardiac valve surgery: a randomised controlled trial.Anaesthesia · 2026Trial
- Review
- Machine Learning-Based Prediction of Prolonged Mechanical Ventilation After Stanford Type A Aortic Dissection Surgery.Journal of multidisciplinary healthcare · 2026Article
- Ultra-fast-track anesthesia in cardiac surgery: perioperative outcomes, patient selection, and implementation strategies-a narrative review.Frontiers in cardiovascular medicine · 2026Review
- Should Topical Ice Slush Be Used Routinely in Cardiac Surgery? Topical Ice Slush in Cardiac Surgery.Journal of clinical medicine · 2025Article
- Postoperative pulmonary complications in acute type A aortic dissection.BMC surgery · 2025Observational
- Article
- Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report.BMC infectious diseases · 2024Article
- Diaphragmatic dysfunction is associated with postoperative pulmonary complications in the aged patients underwent radical resection of esophageal cancer: a prospective observational study.Journal of thoracic disease · 2024Article
- Interest of thoracic ultrasound after cardiac surgery or interventional cardiology.World journal of cardiology · 2024Article
- Perioperative Diaphragm Dysfunction.Journal of clinical medicine · 2024Review
- Diagnosis of hemidiaphragm paralysis: refine ultrasound criteria.Frontiers in medicine · 2024Article
- Ultrasound assessment of diaphragmatic dysfunction in non-critically ill patients: relevant indicators and update.Frontiers in medicine · 2024Review
- Early diaphragm dysfunction assessed by ultrasonography after cardiac surgery: a retrospective cohort study.Frontiers in cardiovascular medicine · 2024Article
- Editorial: Organ support in cardiac intensive care.Frontiers in cardiovascular medicine · 2024Article
- Association of preoperative frailty with pulmonary complications after cardiac surgery in elderly individuals: a prospective cohort study.Aging clinical and experimental research · 2023Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransient diaphragm dysfunction is common during the first week after cardiac surgery; however, the precise incidence, risk factors, and outcomes of persistent diaphragm dysfunction are not well described.
methodsIn a single-centre prospective cohort study, we included all consecutive patients over 18 yr who underwent elective cardiac surgery. Diaphragm function was evaluated with ultrasound (M-mode) by recording the excursion of both hemidiaphragms at two different time points: preoperatively and after the seventh postoperative day in patients breathing without assistance. Significant diaphragm dysfunction after the seventh day of the index cardiac surgery was defined as a decrease in diaphragm excursion below the lower limit of normal: at rest, < 9 mm for women and < 10 mm for men; after a sniff test, < 16 mm for women and < 18 mm for men.
resultsOverall, 122 patients were included in the analysis. The median [interquartile range (IQR)] age was 69 [59-74] years and 96/122 (79%) were men. Ten (8%) patients had diaphragm dysfunction after the seventh postoperative day. We did not identify risk factors for persistent diaphragm dysfunction. Persistent diaphragm dysfunction was associated with a longer median [IQR] duration of noninvasive (8 [0-34] vs 0 [0-0] hr; difference in medians, 8 hr; 95% confidence interval [CI], 0 to 22; P < 0.001) and invasive mechanical ventilation (5 [3-257] vs 3[2-4] hr; difference in medians, 2 hr; 95% CI, 0.5 to 41; P = 0.008); a higher reintubation rate (4/10, 40% vs 1/112, 0.9%; relative risk, 45; 95% CI, 7.1 to 278; P < 0.0001), a higher incidence of pneumonia (4/10 [40%] vs 7/112 [6%]; relative risk, 6; 95% CI, 2 to 16; P < 0.001), and longer median [IQR] length of stay in the intensive care unit (8 [5-29] vs 4 [2-6] days; difference in medians, 4 days; 95% CI, 2 to 12; P = 0.002).
conclusionThe incidence of persistent diaphragm dysfunction was 8% in patients undergoing elective cardiac surgery and was associated with adverse respiratory outcomes. STUDY REGISTRATION: ClinicalTrials.gov (NCT04276844); prospectively registered 19 February 2020.
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