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Introduction
Idiopathic pulmonary fibrosis is a condition characterized by declining function and increasing fibrosis without recognized cause [1]. The prognosis is poor and the median survival after diagnosis is about 2.5 to 3.5 years. But within months, 10 to 15% of cases see an exceptionally rapid decline [2]. The diaphragm is affected by increased elastic recoil. Also, muscle dysfunction is exaggerated by hypoxemia, malnutrition, corticosteroids, systemic inflammation, and inactivity [3].
Functional parameters are affected in idiopathic pulmonary fibrosis and they are useful in evaluating disease severity and prognosis [4].
History and examination are needed for diagnosis with serological tests, computed tomography (CT), and lung functions [5].
Radiographic findings in IPF are characterized by reticular opacities with honeycombing, and traction bronchiectasis, which are usually basal and peripheral [6]. Lung ultrasound (LUS) is used as a diagnostic tool for chest diseases. Diaphragmatic evaluation is an important, safe, and bedside tool to predict weaning [7].
Diaphragmatic excursion (DE) is a lung volume decrease predictor that may be quantified using both B-mode and M-mode approaches [8].
US was also used to measure the diaphragmatic thickness in the area where the diaphragm and rib cage are opposed. The area of the chest wall where the contents of the abdomen reach the lower rib cage is known as the zone of apposition. In this area, the diaphragm is found to be a structure made up of three separate layers: the peritoneum, the diaphragmatic pleura, and the non-echogenic middle layer, which are surrounded by two echogenic layers [9].
The purpose of this investigation was to evaluate the correlation between functional measures and diaphragmatic ultrasonography in individuals with IPF.
Patients and methods
Between November 2023 and April 2024, a prospective case–control investigation was performed on IPF patients who were either attending to outpatient clinic or admitted to Ain Shams University Hospitals and Abbassia Chest Hospital.
This study comprised 45 people in all, who were split up into 3 groups:
Group A: 15 hypoxic IPF patients with progressive disease with long-term oxygen therapy.
Group B: 15 IPF patients do not have hypoxia or respiratory failure.
Group C: 15 healthy individuals matched for age and sex served as controls.
Inclusion criteria
Patients with IPF who were diagnosed agreed with the 2018 ATS/ERS IPF guidelines [10].