Integrating technology in pulmonary practice: ultrasound of the diaphragm, digital drainage systems, and training perspectives
New insights in pulmonary care through ultrasound and digital technology
This thesis of Wytze de Boer explores how modern technology can enhance pulmonary medicine. The first part focuses on ultrasound of the diaphragm, the main muscle of respiration. We demonstrate that this method is a reliable tool for detecting diaphragmatic dysfunction, for example in patients with COPD or following COVID-19. Moreover, ultrasound measurements can help predict which patients are at greater risk of deterioration or hospital readmission, and the technique proves useful for monitoring diaphragmatic recovery over time.
The second part centers on thoracic drainage, used to remove air or fluid from the pleural cavity. Modern digital drainage systems allow chest tubes to be safely removed without the traditional practice of temporary clamping. In some cases, these systems can even be used safely outside the hospital. Ultrasound also showed that after surgery in which the pleura is removed, lung adhesion to the chest wall develops within just a few days.
Finally, we examined how pulmonologists in training learn to use ultrasound. Many residents report limited supervision despite the technique’s growing importance. In collaboration with the national professional society, an educational framework was therefore developed to structurally integrate ultrasound training into pulmonary medicine residency programs.