Diaphragm-protective mechanical ventilation. Issue 1 (February 2019)
- Record Type:
- Journal Article
- Title:
- Diaphragm-protective mechanical ventilation. Issue 1 (February 2019)
- Main Title:
- Diaphragm-protective mechanical ventilation
- Authors:
- Schepens, Tom
Dres, Martin
Heunks, Leo
Goligher, Ewan C. - Abstract:
- Abstract : Purpose of review: Diaphragm dysfunction is common in mechanically ventilated patients and predisposes them to prolonged ventilator dependence and poor clinical outcomes. Mechanical ventilation is a major cause of diaphragm dysfunction in these patients, raising the possibility that diaphragm dysfunction might be prevented if mechanical ventilation can be optimized to avoid diaphragm injury – a concept referred to as diaphragm-protective ventilation. This review surveys the evidence supporting the concept of diaphragm-protective ventilation and introduces potential routes and challenges to pursuing this strategy. Recent findings: Mechanical ventilation can cause diaphragm injury (myotrauma) by a variety of mechanisms. An understanding of these various mechanisms raises the possibility of a new approach to ventilatory management, a diaphragm-protective ventilation strategy. Deranged inspiratory effort is the main mediator of diaphragmatic myotrauma; titrating ventilation to maintain an optimal level of inspiratory effort may help to limit diaphragm dysfunction and accelerate liberation of mechanical ventilation. Summary: Mechanical ventilation can cause diaphragm injury and weakness. A novel diaphragm-protective ventilation strategy, avoiding the harmful effects of both excessive and insufficient inspiratory effort, has the potential to substantially improve outcomes for patients.
- Is Part Of:
- Current opinion in critical care. Volume 25:Issue 1(2019)
- Journal:
- Current opinion in critical care
- Issue:
- Volume 25:Issue 1(2019)
- Issue Display:
- Volume 25, Issue 1 (2019)
- Year:
- 2019
- Volume:
- 25
- Issue:
- 1
- Issue Sort Value:
- 2019-0025-0001-0000
- Page Start:
- Page End:
- Publication Date:
- 2019-02
- Subjects:
- critical illness-associated diaphragm weakness -- diaphragm -- diaphragm myotrauma -- ventilator-induced diaphragm dysfunction
Critical care medicine -- Periodicals
616.028 - Journal URLs:
- http://journals.lww.com/co-criticalcare/pages/default.aspx ↗
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=toc&D=yrovft&AN=00075198-000000000-00000 ↗
http://journals.lww.com/pages/default.aspx ↗
http://firstsearch.oclc.org ↗
http://firstsearch.oclc.org/journal=1070-5295;screen=info;ECOIP ↗
http://www.co-criticalcare.com ↗ - DOI:
- 10.1097/MCC.0000000000000578 ↗
- Languages:
- English
- ISSNs:
- 1070-5295
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 3500.773800
British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 11300.xml