Diaphragm-protective mechanical ventilation in acute respiratory failure
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- Itagaki Taiga
- Department of Emergency and Disaster Medicine, Tokushima University Hospital, Tokushima, Japan
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説明
<p>Mechanical ventilation injures not only the lungs but also the diaphragm, resulting in dysfunction associated with poor outcomes. The chief mechanisms of ventilator-induced diaphragm dysfunction are : disuse atrophy due to insufficient contraction and excessive ventilatory support ; concentric load-induced injury due to excessive contraction and insufficient ventilatory support ; eccentric load-induced injury due to contraction during the expiratory phase ; and longitudinal atrophy caused by high positive end-expiratory pressure. To protect the diaphragm during mechanical ventilation, maintaining proper levels of diaphragm contraction is paramount ; thus, monitoring of respiratory effort and finely tuned ventilator settings are necessary. Furthermore, maintaining of synchronization between the patient and the ventilator is also important. As diaphragm dysfunction is more likely to occur in critically ill patients, diaphragm-protective mechanical ventilation strategies are essential to reduce the mortality rate of intensive care unit patients. This review outlines clinical evidence of ventilator-induced diaphragm dysfunction and its underlying mechanisms, and strategies to facilitate diaphragm-protective mechanical ventilation. J. Med. Invest. 69 : 165-172, August, 2022</p>
収録刊行物
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- The Journal of Medical Investigation
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The Journal of Medical Investigation 69 (3.4), 165-172, 2022
国立大学法人 徳島大学医学部
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詳細情報 詳細情報について
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- CRID
- 1390293788341778688
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- NII書誌ID
- AA11166929
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- ISSN
- 13496867
- 13431420
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- PubMed
- 36244765
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- 本文言語コード
- en
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- 資料種別
- journal article
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- データソース種別
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- JaLC
- IRDB
- Crossref
- PubMed
- KAKEN
- OpenAIRE
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- 抄録ライセンスフラグ
- 使用不可