Basil J Petrof1, Sabah N Hussain. 1. aMeakins Christie Laboratories, and Translational Research in Respiratory Diseases Program, McGill University Health Centre and Research Institute bDepartment of Critical Care, McGill University Health Centre, Montreal, Québec, Canada.
Abstract
PURPOSE OF REVIEW: The purpose of the review is to summarize and discuss recent research regarding the role of mechanical ventilation in producing weakness and atrophy of the diaphragm in critically ill patients, an entity termed ventilator-induced diaphragmatic dysfunction (VIDD). RECENT FINDINGS: Severe weakness of the diaphragm is frequent in mechanically ventilated patients, in whom it contributes to poor outcomes including increased mortality. Significant progress has been made in identifying the molecular mechanisms responsible for VIDD in animal models, and there is accumulating evidence for occurrence of the same cellular processes in the diaphragms of human patients undergoing prolonged mechanical ventilation. SUMMARY: Recent research is pointing the way to novel pharmacologic therapies as well as nonpharmacologic methods for preventing VIDD. The next major challenge in the field will be to move these findings from the bench to the bedside in critically ill patients.
PURPOSE OF REVIEW: The purpose of the review is to summarize and discuss recent research regarding the role of mechanical ventilation in producing weakness and atrophy of the diaphragm in critically illpatients, an entity termed ventilator-induced diaphragmatic dysfunction (VIDD). RECENT FINDINGS: Severe weakness of the diaphragm is frequent in mechanically ventilated patients, in whom it contributes to poor outcomes including increased mortality. Significant progress has been made in identifying the molecular mechanisms responsible for VIDD in animal models, and there is accumulating evidence for occurrence of the same cellular processes in the diaphragms of humanpatients undergoing prolonged mechanical ventilation. SUMMARY: Recent research is pointing the way to novel pharmacologic therapies as well as nonpharmacologic methods for preventing VIDD. The next major challenge in the field will be to move these findings from the bench to the bedside in critically illpatients.
Authors: Martin C J Kneyber; Daniele de Luca; Edoardo Calderini; Pierre-Henri Jarreau; Etienne Javouhey; Jesus Lopez-Herce; Jürg Hammer; Duncan Macrae; Dick G Markhorst; Alberto Medina; Marti Pons-Odena; Fabrizio Racca; Gerhard Wolf; Paolo Biban; Joe Brierley; Peter C Rimensberger Journal: Intensive Care Med Date: 2017-09-22 Impact factor: 17.440