Friday, March 14, 2014


Does Diaphragmatic Inactivity during mechanical ventilation lead to disuse atrophy?

Studies have demonstrated that the combination of 18 to 69 hours of complete diaphragmatic inactivity and mechanical ventilation results in marked atrophy of human diaphragmatic fibers, and that there is increased diaphragmatic proteolysis during inactivity. Compared with diaphragm-biopsy specimens from control subjects, specimens from case subjects showed decreased cross-sectional areas of slow-twitch and fast-twitch fibers, decreased glutathione concentration, and increased activity of proteolytic enzymes.

·          Levine S, Nguyen T, Taylor N, et al. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Engl J Med 2008; 358(13):1327-1335.

·          Kondili E, Alexopoulou C, Xirouchaki N, et al. Estimation of inspiratory muscle pressure in critically ill patients. Intensive Care Med 2010; 36(4):648-655.

·          Petrof BJ, Jaber S, Matecki S. Ventilator-induced diaphragmatic dysfunction. Curr Opin Crit Care 2010; 16 (1):19-25.

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