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Unilateral Paralyzed Hemidiaphragm (UPD)

John R. Burk, MD, FACP and Sandra L. Knaur, APRN, BC Reviewed 06/2019
 


BASICS

DESCRIPTION

Often an incidental finding with chest radiograph 
  • It may not cause resting pulmonary symptoms unless there is underlying comorbidity such as COPD, cardiac disease, muscular weakness,...

DIAGNOSIS

HISTORY

Patients may be asymptomatic. 
  • Dyspnea on exertion/decreased exercise tolerance may be mild to severe unless patient has other underlying pulmonary disease (asthma, COPD, bronchiectasi...

TREATMENT

GENERAL MEASURES

Depends on the underlying cause and in the presence of nocturnal hypoventilation 
  • Metabolic disturbances: Correct electrolyte and/or hormonal imbalances.

  • Nocturnal hypoventilat...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Patient monitoring up to 3 years for possible recovery

  • Periodic/serial chest films

  • Monitor for stability of lung function with serial pulmonary fu...

REFERENCES

1
Benditt JO, Boitano LJ. Pulmonary issues in patients with chronic neuromuscular disease. Am J Respir Crit Care Med.  2013;187(10): 1046–1055. [View Abstract on OvidMedline]
2
Doorduin J...

ADDITIONAL READING

McCool FD, Tzelepis GE. Dysfunction of the diaphragm. N Engl J Med.  2012;366(10):932–942. [View Abstract on OvidMedline] 

CODES

ICD10

J98.6 Disorders of diaphragm 

ICD9

519.4 Disorders of diaphragm 

SNOMED

64228003 paralysis of diaphragm (disorder) 

CLINICAL PEARLS

  • Often an incidental finding with chest radiograph

  • Dyspnea on exertion/decreased exercise tolerance may be mild to severe unless patient has other underlying pulmonary disease (asthma, C...

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