Authors: Giacomo Grasselli, M.D. et al
Anesthesiology 9 2018, Vol.129, 394-395.
Functional impairment of respiratory muscles is considered one of the determinants of difficult weaning from the ventilator which results in prolonged mechanical ventilation and is associated with worse patient outcome. Patients requiring invasive ventilation are exquisitely prone to the development of respiratory muscle dysfunction (including ventilator-induced diaphragmatic dysfunction), which is worsened by a number of concomitant factors like sepsis, electrolyte imbalance, malnutrition, and administration of aminoglicosides, steroids, and neuromuscular blockers. Most of the studies tackling this issue were focused on the dysfunction of inspiratory muscles, mostly the diaphragm. At variance, very few studies aimed at assessing the role of expiratory muscles.