当前位置: X-MOL 学术ICMx › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill
Intensive Care Medicine Experimental Pub Date : 2019-07-01 , DOI: 10.1186/s40635-019-0259-9
Oscar Peñuelas 1, 2 , Elena Keough 1 , Lucía López-Rodríguez 1 , Demetrio Carriedo 1 , Gesly Gonçalves 1 , Esther Barreiro 2, 3, 4 , José Ángel Lorente 1, 2, 5
Affiliation  

Mechanical ventilation [MV] is a life-saving technique delivered to critically ill patients incapable of adequately ventilating and/or oxygenating due to respiratory or other disease processes. This necessarily invasive support however could potentially result in important iatrogenic complications. Even brief periods of MV may result in diaphragm weakness [i.e., ventilator-induced diaphragm dysfunction [VIDD]], which may be associated with difficulty weaning from the ventilator as well as mortality. This suggests that VIDD could potentially have a major impact on clinical practice through worse clinical outcomes and healthcare resource use. Recent translational investigations have identified that VIDD is mainly characterized by alterations resulting in a major decline of diaphragmatic contractile force together with atrophy of diaphragm muscle fibers. However, the signaling mechanisms responsible for VIDD have not been fully established. In this paper, we summarize the current understanding of the pathophysiological pathways underlying VIDD and highlight the diagnostic approach, as well as novel and experimental therapeutic options.

中文翻译:

呼吸机引起的膈肌功能障碍:转化机制导致危重患者的治疗选择

机械通气 [MV] 是一种挽救生命的技术,可用于因呼吸或其他疾病过程而无法充分通气和/或氧合的危重患者。然而,这种必要的侵入性支持可能会导致重要的医源性并发症。即使是短暂的 MV 也可能导致膈肌无力 [即呼吸机引起的膈肌功能障碍 [VIDD]],这可能与呼吸机脱机困难和死亡率有关。这表明 VIDD 可能会通过更糟糕的临床结果和医疗资源使用对临床实践产生重大影响。最近的翻译研究发现 VIDD 的主要特征是改变导致膈肌收缩力显着下降以及膈肌纤维萎缩。然而,负责 VIDD 的信号机制尚未完全建立。在本文中,我们总结了当前对 VIDD 病理生理学途径的理解,并重点介绍了诊断方法,以及新的和实验性的治疗选择。
更新日期:2019-07-01
down
wechat
bug