Author: Thomas Rosenthal
Diaphragm atrophy that develops while patients are mechanically ventilated is specifically associated with increased risks for reintubation, tracheostomy and prolonged ventilation, according to new research.
“The central finding of this study is that the progressive development of diaphragm atrophy during mechanical ventilation is associated with pro longed mechanical ventilation and ICU admission, and an increased risk of complications of acute respiratory failure,” said Ewan C. Goligher, MD, PhD, an assistant professor of medicine at the University of Toronto and a physician-scientist at the Toronto General Hospital Research Institute (Am J Respir Crit Care Med2018;197:204-213).
“We also found that rapid early increases in diaphragm thickness predicted prolonged ventilation, raising the possibility of clinically significant diaphragm injury caused by insufficient respiratory muscle unloading during ventilation,” said Dr. Goligher, who is also the lead author of the study.
The researchers said that for patients with acute respiratory failure, preventing and treating diaphragm atrophy or increased diaphragm thickness may significantly improve outcomes. They believe targeting that threshold of inspiratory effort similar to healthy patients at rest may result in an earlier release from mechanical ventilation.