Prevalence and Kinetics of Diaphragmatic Dysfunction in Elderly Patients With Acute Respiratory Distress

Inclusion criteria

• Patient in spontaneous ventilation at the admission on emergency room
• Presence of acute respiratory distress defined by at least 1 of the following criteria:

• Respiratory rate > 25/min and/or clinical signs of acute respiratory distress,
• Hypoxia defined by Sp02 < 90 %,
• Hypercapnia defined by PaC02 > 45 mmHg with respiratory acidosis defined by a pH value <7.35.
• Absence of opposition of the patient to his participation in the study and the use of his data or the trusted person if the state of the patient does not allow it.

Exclusion criteria

• Presence of a preexisting diaphragmatic dysfunction appearing in the history or the medical file of the patient and explored on the electro-physiological level,
• Patient with acute respiratory distress on arrival at the SAU with clinical criteria justifying immediate use of invasive mechanical ventilation and not allowing ultrasound measurements to be carried out or patient admitted to the SAU with mechanical ventilatory support from the outset,
• Poor command of the French language or state incompatible with the patient's understanding and / or informed adherence to the study protocol,
• History of surgery involving the integrity of the diaphragmatic muscle (diaphragm plication or diaphragmatic lumpectomy or placement of diaphragmatic pacemaker),
• Criteria for shock or severe hemodynamic instability,
• Intra-cranial hypertension.