Diaphragm Training Post-Cardiac Surgery
Diaphragmatic ParalysisDiaphragm paralysis is a possible complication of cardiac surgery. The spontaneous recovery of the diaphragm mobility is slow and partial or absent in most cases. We hypothesize that a program of diaphragm muscle training by means of the Threshold variable resistance device could improve the rate of complete diaphragm mobility recovery in a shorter time period. Patient with post-cardiosurgical diaphragm paralysis will be random assigned to the specific training protocol or to a generic non-training physical activity.
Phrenic Nerve Conduction Study to Diagnose Unilateral Diaphragmatic Paralysis
Unilateral Diaphragmatic ParalysisThe study aims as the principal objective to compare two approaches to diagnosis unilateral diaphragmatic paralysis: transdiaphragmatic pressure (Pdi) measurement versus phrenic nerve conduction (NPC) study. The secondary objective of the study is the strengths and weaknesses of different tests. Diagnostic threshold values.
Assesment of New Devices for the Diagnostic Evaluation of Diaphragmatic Dysfunction
Diaphragmatic ParalysisHealthy Volunteersthis study aim to evaluate wether new, non-invasive and non-contact devices such as Structured Light Plethysmography (SLP) and Sonar would be able to accurately detect and quantify diaphragm dysfunction (mono-or-bilateral) by assessing the asymmetric chest wall motion generated during spontaneous breathing as compared with a classic, standard and invasive technique.
ICU Acquired Neuromyopathy and Diaphragm Function
Critical Illness MyopathyRespiratory ParalysisCritical illness neuromyopathy is a common disease acquired during ICU stay leading to a deep weakness involving the respiratory muscle work which result in a delayed weaning of mechanical ventilation. The main objective is to quantify the loss of diaphragm function by measuring the diaphragm force (using the non invasive method by phrenic nerve stimulation allowing to measure the twitch airway pressure during airway occlusion) in a selected population of patients with critical illness neuromyopathy (defined as a MRC score < 48). The second end points are to evaluate its incidence, the consequences on the patients outcome (extubation success or failure; ICU stay) and to evaluate the relations between diaphragm function (twitch airway pressure during airway occlusion, maximal inspiratory pressure and diaphragm thickness evaluated by ultrasound) and peripheral limbs force (evaluated by the Medical Research Council - MRC score).
Diaphragmatic Paralysis in Arthroscopic Shoulder Surgery
DyspneaHypoxia1 moreThis study aims to assess consequences and causes of hemidiaphragmatic paralysis for ambulatory arthroscopic shoulder surgery in patients with BMI ≥ 30 kg/m².
Respiratory Muscle Strength and Function in Neuromuscular Disorders and Chronic Obstructive Pulmonary...
Respiratory Muscle ParalysisUsing an extensive set of both volitional and non-volitional tests of respiratory muscle function and strength it is the aim of this study to identify disease-specific patterns of respiratory muscle impairment in different NMD and COPD establish which set of tests is predictive of sleep-disordered breathing or daytime hypercapnia in patients with NMD or COPD, respectively. to investigate the decline of respiratory muscle function in patients with progressive NMD and COPD along with sleep studies and capnography
The Relationship Between Trans-diaphragmatic Pressure and Diaphragmatic Contraction
Weaning FailureRespiratory Paralysis1 moreThrough this study the investigators aim to clarify the relationship between trans-diaphragmatic pressure and various parameters of the diaphragmatic contraction evaluated by ultrasound. The following parameters will be studied: esophageal pressure, gastric pressure, diaphragm thickness at peak inspiration (Tdi,pi), diaphragm thickness at end expiration (Tdi,ee), diaphragm thickening (Tdi,pi - Tdi,ee), diaphragm thickness fraction [TFdi=(Tdi,pi - Tdi,ee)/Tdi,ee], diaphragm excursion (Di,e), Maximal Inspiratory pressure (M.I.P), Pressure-Time product of the trans-diaphragmatic pressure (PΤPdi),Tension Time Diaphragm Index (T.T.Di) and the rapid shallow breathing index (R.S.B.I.). These measurements will be made in two phases.Firstly, during the spontaneous breathing trial and secondly during spontaneous breathing through an airway of reduced diameter.Furthermore, during the M.I.P. test the aforementioned ultrasound parameters will be measured. The aim of this study is to discover new means of a successful prediction of weaning in the first 48 hours following extubation.
Regional Distribution of Ventilation to Assess Respiratory Muscle Dysfunction
Respiratory FailureNeuromuscular Disorder1 moreThe aim of this study is to better discriminate respiratory muscle dysfunction by comparing the measurements of thoracoabdominal motion obtained by an optoelectronic recording and the conventional tests of respiratory muscle strength. The final objective is to better select in the future the patients who need more specific assessment of diaphragmatic function like "maximal transdiaphragmatic pressure" measurement and "phrenic nerve stimulation".