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BACKGROUND: Ultrasound-based diaphragmatic thickness fraction is a reflection of the size and function of the diaphragm. This study aimed to examine the value of this measurement in identifying patients with COPD who are at high risk for the development of symptoms and exacerbations. METHODS: This cross-sectional study included 53 subjects with COPD. Respiratory function test results, ultrasonography-based diaphragmatic thickness, symptom scores (modified Medical Research Council dyspnea scale); COPD Assessment Test results, and number of previous exacerbations and admissions were recorded. RESULTS: Only age showed an inverse and weak relation with percent thickness fraction (r = -0.37, P = .006). None of the other variables tested correlated significantly with percent thickness fraction. No association was found between percent thickness fraction and exacerbation frequency, modified Medical Research Council dyspnea scale and COPD Assessment Test symptom scores, or Global Initiative for Chronic Obstructive Lung Disease ABCD risk/symptom assessments. CONCLUSIONS: Diaphragmatic thickness fraction measurements based on diaphragmatic ultrasound assessment in subjects with COPD seemed to be unable to identify subjects at high risk of symptoms and exacerbations as defined by the Global Initiative for Chronic Obstructive Lung Disease ABCD composite disease index. [ABSTRACT FROM AUTHOR]

Purpose: To develop an equation to calculate the bedside dynamic mechanical power (MP dyn ) for modern ventilators using the Work of Breathing ventilator (WOBv) parameter., Materials and Methods: We developed an equation based on mechanical power values, which is equal to WOBv x minute volume. To measure mechanical power with this equation forty adult patients, hospitalized with the diagnosis of Acute Respiratory Distress Syndrome and underwent invasive mechanical ventilation, were used. To be able compare our results with Gattinoni's standart mechanical power equation (MP std ) the contribution of the PEEP was included in our equation. Then results obtained from MP dyn and MP std were compared using univariable regression and Bland-Altman analysis. This comparison was performed at different I:E ratios, PEEP levels and tidal volumes., Results: Analysis of the results for each condition showed that MP dyn and MP std equation correlated with R 2  ≥ 0.98. Additionally, there was no statistically significant difference between MP dyn and MP std for patient power means were 0.04 J/min (p = .42) using Bland-Altman analysis., Conclusions: Physicians can easily calculate mechanical power by using MP dyn at the bedside of patients on volume control mode., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier Inc. All rights reserved.)