Diaphragmatic paralysis medical therapy: Difference between revisions

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Latest revision as of 21:22, 29 July 2020

Diaphragmatic Paralysis Microchapters

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Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Diaphragmatic Paralysis from other Diseases

Epidemiology and Demographics

Risk Factors

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Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

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Treatment

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Cost-Effectiveness of Therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2] [3] [4] [5] [6]

Overview

No treatment is required for unilateral diaphragmatic paralysis because most patients are asymptomatic. In bilateral diaphragmatic paralysis treatment options are ventilatory support and diaphragmatic pacing.

Medical Therapy

Unilateral diaphragmatic paralysis

  • No treatment are required in unilateral diaphragmatic paralysis because most patients are asymptomatic.[1]
  • Transient ventilatory support with noninvasive positive pressure ventilation (NPPV) or invasive mechanical ventilation: it is used when patients with unilateral diaphragmatic paralysis develop acute respiratory dysfunction after general anesthesia or infections.

Bilateral diaphragmatic paralysis

  • Treatment options depends upon the severity of paralysis of the diaphragm and etiology. [2][3]
  • Ventilatory support (invasive or noninvasive)
  • Diaphragmatic pacing:

Diaphragmatic paralysis

Antiviral therapy for viral etiology of diaphragmatic paralysis:[6]


References

  1. Easton PA, Fleetham JA, de la Rocha A, Anthonisen NR (January 1983). "Respiratory function after paralysis of the right hemidiaphragm". Am. Rev. Respir. Dis. 127 (1): 125–8. doi:10.1164/arrd.1983.127.1.125. PMID 6849536.
  2. Davis J, Goldman M, Loh L, Casson M (January 1976). "Diaphragm function and alveolar hypoventilation". Q. J. Med. 45 (177): 87–100. PMID 1062815.
  3. Gibson GJ (November 1989). "Diaphragmatic paresis: pathophysiology, clinical features, and investigation". Thorax. 44 (11): 960–70. PMC 462156. PMID 2688182.
  4. Le Pimpec-Barthes F, Legras A, Arame A, Pricopi C, Boucherie JC, Badia A, Panzini CM (April 2016). "Diaphragm pacing: the state of the art". J Thorac Dis. 8 (Suppl 4): S376–86. doi:10.21037/jtd.2016.03.97. PMC 4856845. PMID 27195135.
  5. Onders RP, Elmo M, Khansarinia S, Bowman B, Yee J, Road J, Bass B, Dunkin B, Ingvarsson PE, Oddsdóttir M (July 2009). "Complete worldwide operative experience in laparoscopic diaphragm pacing: results and differences in spinal cord injured patients and amyotrophic lateral sclerosis patients". Surg Endosc. 23 (7): 1433–40. doi:10.1007/s00464-008-0223-3. PMID 19067067.
  6. Crausman RS, Summerhill EM, McCool FD (2009). "Idiopathic diaphragmatic paralysis: Bell's palsy of the diaphragm?". Lung. 187 (3): 153–7. doi:10.1007/s00408-009-9140-z. PMID 19277778.

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