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Original Research: Critical Care |

Optoelectronic Plethysmography as an Alternative Method for the Diagnosis of Unilateral Diaphragmatic WeaknessChest Wall Motion and Hemidiaphragm Weakness

Julien Boudarham, MSc; Didier Pradon, PhD; Hélène Prigent, MD, PhD; Line Falaize; Marie-Christine Durand, MD, PhD; Henri Meric, MSc; Michel Petitjean, MD, PhD; Frédéric Lofaso, MD, PhD
Author and Funding Information

From the Centre d’Innovations Technologiques (Messrs Boudarham and Meric; Drs Pradon, Prigent, Durand, and Lofaso; and Ms Falaize), UMR 805, Hôpital Raymond Poincaré, AP-HP, 92380, Garches; Physiologie - Explorations Fonctionnelles (Dr Petitjean), Hôpital Ambroise Paré, AP-HP, 92104, Boulogne; Université de Versailles Saint-Quentin-en-Yvelines (Messrs Boudarham and Meric; Drs Pradon, Prigent, Durand, Petitjean, and Lofaso; and Ms Falaize), EA 4497, 78180 Montigny-le-Bretonneux, Versailles; Center Hospitalier Universitaire d’Amiens (Dr Petitjean), Amiens; and INSERM U855 (Dr Lofaso), 94000 Créteil, France.

Correspondence to: Frédéric Lofaso, MD, PhD, Centre d’Innovations Technologiques, UMR 805, Hôpital Raymond Poincaré, 92380 Garches, France; e-mail: f.lofaso@rpc.ap-hop-paris.fr


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(3):887-895. doi:10.1378/chest.12-2317
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Background:  The objective was to determine whether optoelectronic plethysmography (OEP) can detect asymmetric ventilation related to unilateral or asymmetric diaphragmatic weakness, suggesting usefulness as a diagnostic tool.

Methods:  Thirteen patients with suspected asymmetric diaphragmatic weakness based on dyspnea and hemidiaphragm elevation on the chest radiograph were studied as well as three patients with maltase acid deficiency (a cause of symmetrical diaphragmatic weakness). The transdiaphragmatic pressure response to unilateral magnetic stimulation (lateral twitch transdiaphragmatic pressure [latPdiTw]) and the diaphragm compound muscle action potentials (CMAPs) elicited by transcutaneous electrical stimulation of each phrenic nerve as well as OEP were performed.

Results:  The CMAPs and latPdiTw showed unilateral or predominantly unilateral diaphragmatic weakness in nine of the 13 patients. By OEP, the affected side of the thorax and abdomen contributed < 45% of the inspiratory capacity in each of these nine patients, whereas no asymmetry was noted in the other four patients or in the three patients with maltase acid deficiency. All patients preferred OEP over CMAP or latPdiTw.

Conclusions:  OEP detected asymmetric ventilation in all patients diagnosed with unilateral diaphragm weakness and in no patients without this diagnosis. Thus, OEP is an effective noninvasive alternative that is preferred by the patients over CMAP response and latPdiTw.

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