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Ventilator-induced diaphragmatic dysfunction: what have we learned?

Petrof, Basil J.; Hussain, Sabah N.

Current Opinion in Critical Care: February 2016 - Volume 22 - Issue 1 - p 67–72
doi: 10.1097/MCC.0000000000000272
RESPIRATORY SYSTEM: Edited by Marco Ranieri
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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.

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

Correspondence to Basil J. Petrof, MD, Meakins-Christie Laboratories, 1001 Decarie Boulevard, Montreal, QC H4A 3J1, Canada. Tel: +514 934 1934; ext 76172; fax: +514 398 7483; e-mail: basil.petrof@mcgill.ca

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