Abstract：
INTRODUCTION:Mechanical ventilation is associated with ventilator-induced diaphragmatic dysfunction (VIDD) in animal models and also in humans. BACKGROUND:The main pathophysiological pathways implicated in VIDD seems to be related to muscle inactivity but may also be the consequence of high tidal volumes. Systemic insults from side effects of medication, infection, malnutrition and hypoperfusion also play a part. The diaphragm is caught in the cross-fire of ventilation-induced and systemic-induced dysfunctions. Intracellular consequences of VIDD include oxidative stress, proteolysis, impaired protein synthesis, autophagy activation and excitation-contraction decoupling. VIDD can be diagnosed at the bedside using non-invasive magnetic stimulation of the phrenic nerves which is the gold standard. Other techniques involve patient's participation such as respiratory function tests or ultrasound examination. CONCLUSION AND PERSPECTIVES:At this date, only spontaneous ventilatory cycles and perhaps phrenic nerve stimulation appear to diminish the severity of VIDD in humans but several pathways are currently being examined using animal models. Specific pharmacological options are currently under investigation in animal models.
journal_name
Rev Mal Respirjournal_title
Revue des maladies respiratoiresauthors
Jung B,Gleeton D,Daurat A,Conseil M,Mahul M,Rao G,Matecki S,Lacampagne A,Jaber Sdoi
10.1016/j.rmr.2014.08.013subject
Has Abstractpub_date
2015-04-01 00:00:00pages
370-80issue
4eissn
0761-8425issn
1776-2588pii
S0761-8425(14)01142-5journal_volume
32pub_type
杂志文章,评审abstract：:The majority of smokers who stop smoking do it alone. The methods of stopping are aimed at helping those who cannot achieve this. The different methods used include psycho-therapy (individual-group), medication, and in the first place is nicotine chewing-gum (but also clonidine which opens a new perspective), aversive...
journal_title：Revue des maladies respiratoires
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journal_title：Revue des maladies respiratoires
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journal_title：Revue des maladies respiratoires
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doi：
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