Diaphragm Ultrasonography as a Tool To Assess the Respiratory Issues of a Patient With Amyotrophic Lateral Sclerosis (ALS).
On examination, the patient was in respiratory distress. The blood pressure, pulse rate, respiratory rate, temperature, and oxygen saturation were 158/108 mmHg, 108 beats per minute, 30 breaths per minute, 36.4 °C, and 92%, respectively while she was breathing ambient air. Physical examination revealed paradoxical breathing with the chest wall moving inwards during inspiration and outwards during expiration (Video 1) together with diffuse inspiratory and expiratory wheezes of Jonson Grade 3. On examination, the patient was in respiratory distress. The blood pressure, pulse rate, respiratory rate, temperature, and oxygen saturation were 158/108 mmHg, 108 beats per minute, 30 breaths per minute, 36.4 °C, and 92%, respectively while she was breathing ambient air. Physical examination revealed paradoxical breathing with the chest wall moving inwards during inspiration and outwards during expiration (Video 1) together with diffuse inspiratory and expiratory wheezes of Jonson Grade 3.
Her condition worsened despite the aggressive therapy with intravenous methylprednisolone and albuterol by nebulizer and pulsus paradoxus (30 mmHg:210/180) was observed on day 5 of hospitalization (Video 4). On examination, the patient was in respiratory distress. The blood pressure, pulse rate, respiratory rate, temperature, and oxygen saturation were 158/108 mmHg, 108 beats per minute, 30 breaths per minute, 36.4 °C, and 92%, respectively while she was breathing ambient air. Physical examination revealed paradoxical breathing with the chest wall moving inwards during inspiration and outwards during expiration (Video 1) together with diffuse inspiratory and expiratory wheezes of Jonson Grade 3.
Pulm Res Respir Med Open J. 2016; SE(1): S14-S16. doi:10.17140/PRRMOJ-SE-1-105
