Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill

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....

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Autores: Peñuelas, Oscar, Keough, Elena, López-Rodríguez, Lucía, Carriedo, Demetrio, Gonçalves, Gesly, Barreiro Portela, Esther, Lorente, José Ángel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/43427
Acceso en línea:http://hdl.handle.net/10230/43427
http://dx.doi.org/10.1186/s40635-019-0259-9
Access Level:acceso abierto
Palabra clave:Critically ill patient
Diaphragm dysfunction
Diaphragmatic fatigue
Mechanical ventilation
Respiratory muscles
Weaning failure
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spelling Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically illPeñuelas, OscarKeough, ElenaLópez-Rodríguez, LucíaCarriedo, DemetrioGonçalves, GeslyBarreiro Portela, EstherLorente, José ÁngelCritically ill patientDiaphragm dysfunctionDiaphragmatic fatigueMechanical ventilationRespiratory musclesWeaning failureMechanical 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.Elsevier202020202019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/43427http://dx.doi.org/10.1186/s40635-019-0259-9reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésIntensive Care Medicine Experimental. 2019 Jul 25;7(Suppl 1):48The Author(s). 2019 Open Access.This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/434272026-06-12T07:21:37Z
dc.title.none.fl_str_mv Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill
title Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill
spellingShingle Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill
Peñuelas, Oscar
Critically ill patient
Diaphragm dysfunction
Diaphragmatic fatigue
Mechanical ventilation
Respiratory muscles
Weaning failure
title_short Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill
title_full Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill
title_fullStr Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill
title_full_unstemmed Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill
title_sort Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill
dc.creator.none.fl_str_mv Peñuelas, Oscar
Keough, Elena
López-Rodríguez, Lucía
Carriedo, Demetrio
Gonçalves, Gesly
Barreiro Portela, Esther
Lorente, José Ángel
author Peñuelas, Oscar
author_facet Peñuelas, Oscar
Keough, Elena
López-Rodríguez, Lucía
Carriedo, Demetrio
Gonçalves, Gesly
Barreiro Portela, Esther
Lorente, José Ángel
author_role author
author2 Keough, Elena
López-Rodríguez, Lucía
Carriedo, Demetrio
Gonçalves, Gesly
Barreiro Portela, Esther
Lorente, José Ángel
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Critically ill patient
Diaphragm dysfunction
Diaphragmatic fatigue
Mechanical ventilation
Respiratory muscles
Weaning failure
topic Critically ill patient
Diaphragm dysfunction
Diaphragmatic fatigue
Mechanical ventilation
Respiratory muscles
Weaning failure
description 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.
publishDate 2019
dc.date.none.fl_str_mv 2019
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/43427
http://dx.doi.org/10.1186/s40635-019-0259-9
url http://hdl.handle.net/10230/43427
http://dx.doi.org/10.1186/s40635-019-0259-9
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Intensive Care Medicine Experimental. 2019 Jul 25;7(Suppl 1):48
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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