Tuesday, March 20, 2018

VIDD

Q:  Ventilator-induced diaphragmatic dysfunction (VIDD) can be evident as early as within first 24 hours of initiation of mechanical ventilation?

A) True
B) False


Answer: A (True)

It is now an established fact that mechanical ventilation can cause diaphragmatic muscle atrophy. The term designated for this phenomenon is known as ventilator induced diaphragmatic dysfunction (VIDD). Studies have shown that it may be evident as early as by the eighteenth hour of the initiation of positive pressure ventilation 1. When it comes to VIDD, any mechanical ventilation more than 24 hours is considered as a long-term mechanical ventilation! 2 VIDD is an umbrella term for muscle injury, atrophy, and proteolysis. The probable cause of VIDD is oxidative stress. This is a worrisome phenomenon as VIDD itself cause difficulty weaning from mechanical ventilation and ICU outcomes 3.


References:

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

2. Jaber S, Petrof BJ, Jung B, et al. Rapidly progressive diaphragmatic weakness and injury during mechanical ventilation in humans. Am J Respir Crit Care Med 2011; 183:364.  

Goligher EC, Dres M, Fan E, et al. Mechanical Ventilation-induced Diaphragm Atrophy Strongly Impacts Clinical Outcomes. Am J Respir Crit Care Med 2018; 197:204.

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