@article {Boussuges00714-2020, author = {Alain Boussuges and Julie Finance and Guillaume Chaumet and Fabienne Br{\'e}geon}, title = {Diaphragmatic motion recorded by M-mode ultrasonography: limits of normality}, elocation-id = {00714-2020}, year = {2021}, doi = {10.1183/23120541.00714-2020}, publisher = {European Respiratory Society}, abstract = {Background Chest ultrasonography has proven to be useful in the diagnosis of diaphragm dysfunction. The aim of the present study was to determine the normal values of the motion of both hemidiaphragms recorded by M-mode ultrasonography.Methods Healthy volunteers were studied while in a seated position. Diaphragmatic excursions and diaphragm profiles were measured during quiet breathing, voluntary sniffing, and deep breathing. Diaphragmatic excursions were assessed by M-mode ultrasonography, using an approach perpendicular to the posterior part of the diaphragm. Anatomical M-mode was used for the recording of the complete excursion during deep breathing.Results The study included 270 men and 140 women. The diaphragmatic motions during quiet breathing and voluntary sniffing were successfully recorded in all of the participants. The use of anatomical M-mode was particularly suitable for measurement of the entire diaphragmatic excursion during deep breathing. The statistical analysis showed that the diaphragmatic excursions were larger in men compared to women, supporting the determination of normal values based on gender. The lower and upper limits of normal excursion were determined for men and women for both hemidiaphragms during the three maneuvers that were investigated. The lower limits of normal diaphragmatic excursions during deep breathing should be used to detect diaphragmatic hypokinesia, i.e., 3.3 and 3.2 cm in women and 4.1 and 4.2 cm in men for the right and the left sides, respectively.Conclusion The normal values of the diaphragmatic motion and the lower and upper limits of normal excursion can be used by clinicians to detect diaphragmatic dysfunction.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. BOUSSUGES has nothing to disclose.Conflict of interest: Dr. Finance has nothing to disclose.Conflict of interest: G. ChaumetConflict of interest: Dr. BREGEON has nothing to disclose.}, URL = {https://openres.ersjournals.com/content/early/2021/01/14/23120541.00714-2020}, eprint = {https://openres.ersjournals.com/content/early/2021/01/14/23120541.00714-2020.full.pdf}, journal = {ERJ Open Research} }