Wertigkeit der Sonographie auf der Intensivstation zur Diagnostik von Zwerchfellparesen

Purpose: To assess the value of bedside sonography in the detection of diaphragmatic paralysis in patients in the intensive care unit, Methods: In this study, 100 patients who were admitted to the intensive care unit after thoracic operations were evaluated. Sonography of each hemidiaphragm was performed with coronal scans at the mid-axillary line on both sides with the patient supine. Absent and paradoxical diaphragmatic movement was considered to be indicative of diaphragmatic paralysis. All patients underwent additional fluoroscopy within 5 days. Results: In 13 patients (13%) sonography revealed diaphragmatic paralysis. All these results were confirmed with fluoroscopy resulting in a sensitivity and specificity for sonography of 100%. Conclusion: Bedside sonography of the diaphragm at the intensive care unit is a reliable tool for diagnosing diaphragmatic paralysis.