Abstract
A completely different treatment approach was chosen for 2 patients with unilateral diaphragmatic paralysis and complaints of dyspnea despite similar anatomic and physiologic abnormalities. These decisions were supported by results obtained by functional respiratory imaging (FRI). FRI generated functional information on lobar ventilation and local drug deposition. In the first patient, some lobes were poorly ventilated, and drug deposition simulation showed that some regions were undertreated. This patient underwent diaphragmatic plication to restore ventilation. In the second patient, all lobes were still ventilated. A conservative approach with regular follow-ups was chosen to wait for spontaneous recovery of the diaphragmatic function. Both patients improved subjectively and objectively. These cases demonstrate how novel medical imaging techniques such as FRI can be used to personalize respiratory treatment in patients with unilateral diaphragmatic paralysis.
- MeSH
- diaphragmatic paralysis
- thoracic surgery
- pulmonary ventilation
- respiratory drug administration
- computer-assisted decision making
- personalized medicine
Footnotes
- Correspondence: Cedric S Van Holsbeke PhD, Fluidda nv, Groeningenlei 132, 2550 Kontich, Belgium. E-mail: cedric.vanholsbeke{at}fluidda.com.
Drs JW De Backer and WA De Backer are shareholders and board members of Fluidda nv. Drs Van Holsbeke, Vos, and Vinchurkar are employed by Fluidda nv. The other authors have disclosed no conflicts of interest.
Mr Leemans presented a version of this paper at the ERS Annual Congress 2013, held September 7–11, 2013, in Barcelona, Spain.
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