Critical illness-associated diaphragm weakness

Martin Dres, Ewan C. Goligher, Leo M.A. Heunks, Laurent J. Brochard

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Diaphragm weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilation but it also frequently develops during the ICU stay. Several risk factors for diaphragm weakness have been identified; among them sepsis and mechanical ventilation play central roles. We employ the term critical illness-associated diaphragm weakness to refer to the collective effects of all mechanisms of diaphragm injury and weakness occurring in critically ill patients. Critical illness-associated diaphragm weakness is consistently associated with poor outcomes including increased ICU mortality, difficult weaning, and prolonged duration of mechanical ventilation. Bedside techniques for assessing the respiratory muscles promise to improve detection of diaphragm weakness and enable preventive or curative strategies. Inspiratory muscle training and pharmacological interventions may improve respiratory muscle function but data on clinical outcomes remain limited.

Original languageEnglish
Pages (from-to)1441-1452
Number of pages12
JournalIntensive Care Medicine
Volume43
Issue number10
DOIs
Publication statusPublished - 1 Oct 2017

Cite this

Dres, Martin ; Goligher, Ewan C. ; Heunks, Leo M.A. ; Brochard, Laurent J. / Critical illness-associated diaphragm weakness. In: Intensive Care Medicine. 2017 ; Vol. 43, No. 10. pp. 1441-1452.
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Critical illness-associated diaphragm weakness. / Dres, Martin; Goligher, Ewan C.; Heunks, Leo M.A.; Brochard, Laurent J.

In: Intensive Care Medicine, Vol. 43, No. 10, 01.10.2017, p. 1441-1452.

Research output: Contribution to journalReview articleAcademicpeer-review

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T1 - Critical illness-associated diaphragm weakness

AU - Dres, Martin

AU - Goligher, Ewan C.

AU - Heunks, Leo M.A.

AU - Brochard, Laurent J.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Diaphragm weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilation but it also frequently develops during the ICU stay. Several risk factors for diaphragm weakness have been identified; among them sepsis and mechanical ventilation play central roles. We employ the term critical illness-associated diaphragm weakness to refer to the collective effects of all mechanisms of diaphragm injury and weakness occurring in critically ill patients. Critical illness-associated diaphragm weakness is consistently associated with poor outcomes including increased ICU mortality, difficult weaning, and prolonged duration of mechanical ventilation. Bedside techniques for assessing the respiratory muscles promise to improve detection of diaphragm weakness and enable preventive or curative strategies. Inspiratory muscle training and pharmacological interventions may improve respiratory muscle function but data on clinical outcomes remain limited.

AB - Diaphragm weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilation but it also frequently develops during the ICU stay. Several risk factors for diaphragm weakness have been identified; among them sepsis and mechanical ventilation play central roles. We employ the term critical illness-associated diaphragm weakness to refer to the collective effects of all mechanisms of diaphragm injury and weakness occurring in critically ill patients. Critical illness-associated diaphragm weakness is consistently associated with poor outcomes including increased ICU mortality, difficult weaning, and prolonged duration of mechanical ventilation. Bedside techniques for assessing the respiratory muscles promise to improve detection of diaphragm weakness and enable preventive or curative strategies. Inspiratory muscle training and pharmacological interventions may improve respiratory muscle function but data on clinical outcomes remain limited.

KW - Critically ill patients

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