Treatment of Symptomatic Unilateral Diaphragmatic Dysfunction

Unilateral diaphragmatic dysfunction becomes clinically significant when the patient is symptomatic — experiencing dyspnoea and impaired respiratory mechanics attributable to paradoxical movement of the affected hemidiaphragm.

Clinical Scenario

In symptomatic patients with unilateral diaphragmatic dysfunction, the abnormal excursion of the involved hemidiaphragm contributes to ventilatory inefficiency and breathlessness, warranting an active interventional approach.

Treatment Approach (partial)

The established surgical approach targets the affected hemidiaphragm directly, with the goal of mechanically correcting its paradoxical movement. The procedure can be performed through more than one operative route.

Full procedural detail, surgical specifics, and the complete decision algorithm are available in the structured protocol.

Treatment Goals

Clinical success is defined by reduced dyspnoea, decreased paradoxical diaphragmatic movement, and measurable improvements in tidal volumes and ventilatory frequency.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1183/20734735.0218-2024

In symptomatic patients with unilateral diaphragmatic dysfunction, surgical plication of the affected hemidiaphragm is a procedure to consider.

Its main objective is to reduce dyspnoea by immobilising the involved hemidiaphragm in a position of maximal inspiration, thereby decreasing its paradoxical movement.

Furthermore, this improvement in lung function was also shown by WELVAART et al., demonstrating that plication leads to improved tidal volumes and reduced ventilatory frequency.

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