ANALYSIS OF THE POSITION AND MOBILITY OF THE DIAPHRAGM IN ADULTS WITH NORMAL LUNG FUNCTION BEFORE AND AFTER CARDIAC SURGERY

A statistical  analysis of position and mobility of the diaphragm  in adults with normal lung function is not operated and underwent various cardiac interventions. The study included 2441 the patient,  divided into groups non-operated and undergoing  various cardiac surgical intervention.  Were determined  the mean values of the position and mobility of the diaphragm,  the frequency of elevation and diaphragm dysfunction. Using ROC analysis established  the degree of influence for the elevation and dysfunction of the diaphragm of the body mass index (BMI), the coefficient of mobility of the diaphragm  (CMD)  and indicators  of the position of the domes of the diaphragm.  It is revealed that after cardiac operations  the position of the domes of the diaphragm was higher and decreased  mobility of the diaphragm. Elevation and dysfunction among non-operated diaphragm was noted in a few cases, and after cardiac surgery significantly more often. Non-operated patients  have a statistically  significant impact on elevation of the right dome had a value of (AUC 0,99) and the elevation of the left dome of the diaphragm the magnitude  of BMI (AUC of 0,89). They have not identified effects on diaphragmatic  dysfunction none of the studied factors. In postoperative  patients, the rates of mobility of the diaphragm showed a good effect on the elevation (AUC of 0,84–0,86), while the value of BMI showed an average quality of effects in all models (AUC of 0,62 to 0,65). A statistically significant effect on diaphragm matic dysfunction provided only the position of the domes of the diaphragm (AUC 0,78–0,83). Patients undergoing different cardiac surgical intervention have a statistically significant decrease of mobility and increase the position of the diaphragm,  increasing the frequency of elevation and dysfunction. From non-operated patients  on the mobility of the diaphragm did not affect any height standing  domes of the diaphragm or BMI. On the position of the right dome affects only the rate of mobility of the diaphragm, and the left dome — the value of BMI. Patients after various cardiac surgeries  greater  impact on the elevation of the diaphragm provided an indicator of its mobility, than BMI and dysfunction of the diaphragm affects only its position.

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