Critical Care

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Commentary

Pressure support ventilation attenuates ventilator-induced protein modifications in the diaphragm

Scott K Powers1*, Marc DeCramer2, Ghislaine Gayan-Ramirez2 and Sanford Levine3

Author Affiliations

1 Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32608, USA

2 Respiratory Rehabilitation and Respiratory Division, University Hospitals, Catholic University of Leuven, B-3000 Leuven, Belgium

3 Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA

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Critical Care 2008, 12:191 doi:10.1186/cc7095


See related research by Futrer et al., http://ccforum.com/content/12/5/R116

Published: 7 November 2008

Abstract

Common medical conditions that require mechanical ventilation include chronic obstructive lung disease, acute lung injury, sepsis, heart failure, drug overdose, neuromuscular disorders, and surgery. Although mechanical ventilation can be a life saving measure, prolonged mechanical ventilation can also present clinical problems. Indeed, numerous well-controlled animal studies have demonstrated that prolonged mechanical ventilation results in diaphragmatic weakness due to both atrophy and contractile dysfunction. Importantly, a recent clinical investigation has confirmed that prolonged mechanical ventilation results in atrophy of the human diaphragm. This mechanical ventilation-induced diaphragmatic weakness is important because the most frequent cause of weaning difficulty is respiratory muscle failure due to inspiratory muscle weakness and/or a decline in inspiratory muscle endurance. Therefore, developing methods to protect against mechanical ventilation-induced diaphragmatic weakness is important.