Améliorer la qualité des soins et le devenir des patients atteints de pathologies pulmonaires obstructives : application clinique d'un nouvel outil diagnostique et pronostique par le monitoring échographique de l'activité diaphragmatique

 

Bruno-Pierre Dubé

Centre hospitalier de l'Université de Montréal [CHUM]

 

Domaine : santé circulatoire et respiratoire

Programme Chercheurs-boursiers cliniciens - Junior 1

Concours 2018-2019

The quality of life and evolution of patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) are strongly influenced by episodes of "acute exacerbations". These events are defined as rapid deterioration of the respiratory status, are often related to a pulmonary infection, and represent a heavy burden for patients and the healthcare system. The optimal management of exacerbations is difficult because there are few objective and reliable tools that can adequately identify their presence and guide their management. Recently, ultrasound measurement of the activity of the diaphragm, the primary respiratory muscle, has been proposed as a method that allows a rapid, simple and reliable measurement of the state of the respiratory system. This technique could therefore help doctors to better assess the condition of patients with chronic respiratory diseases, but has not yet been evaluated in this population.

Given the critical need for a reliable tool that would help improve the management of these exacerbations, this research program aims to establish the added value of the diaphragm ultrasound technique in this context.

To achieve this, this technique will be evaluated as: 1) a new marker of disease severity in CF patients in the stable state, 2) a tool to identify the presence of an exacerbation more rapidly in CF patients and 3) a new marker to identify that an exacerbation episode is resolved and controlled in COPD patients.

These innovative projects aim at positioning the technique of diaphragm ultrasound as a new, simple, efficient, accessible and reliable tool that would allow physicians to improve the treatment of patients with chronic respiratory diseases. Ultimately, the objective of these projects is to improve not only the medical management of these patients, but also their prognosis and quality of life.