Diaphragm Dysfunction in Critical Illness

Gerald S. Supinski, Peter E. Morris, Sanjay Dhar, Leigh Ann Callahan

Research output: Contribution to journalReview articlepeer-review

122 Scopus citations

Abstract

The diaphragm is the major muscle of inspiration, and its function is critical for optimal respiration. Diaphragmatic failure has long been recognized as a major contributor to death in a variety of systemic neuromuscular disorders. More recently, it is increasingly apparent that diaphragm dysfunction is present in a high percentage of critically ill patients and is associated with increased morbidity and mortality. In these patients, diaphragm weakness is thought to develop from disuse secondary to ventilator-induced diaphragm inactivity and as a consequence of the effects of systemic inflammation, including sepsis. This form of critical illness-acquired diaphragm dysfunction impairs the ability of the respiratory pump to compensate for an increased respiratory workload due to lung injury and fluid overload, leading to sustained respiratory failure and death. This review examines the presentation, causes, consequences, diagnosis, and treatment of disorders that result in acquired diaphragm dysfunction during critical illness.

Original languageEnglish
Pages (from-to)1040-1051
Number of pages12
JournalChest
Volume153
Issue number4
DOIs
StatePublished - Apr 2018

Bibliographical note

Publisher Copyright:
© 2017 American College of Chest Physicians

Keywords

  • ICU acquired weakness
  • diaphragm weakness
  • mechanical ventilation
  • ultrasound

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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