Powers Scott K, DeCramer Marc, Gayan-Ramirez Ghislaine, Levine Sanford
Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32608, USA.
Crit Care. 2008;12(6):191. doi: 10.1186/cc7095. Epub 2008 Nov 7.
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.
需要机械通气的常见医疗状况包括慢性阻塞性肺疾病、急性肺损伤、败血症、心力衰竭、药物过量、神经肌肉疾病和手术。尽管机械通气可以是一种挽救生命的措施,但长时间的机械通气也会带来临床问题。事实上,大量严格控制的动物研究表明,长时间的机械通气会由于萎缩和收缩功能障碍导致膈肌无力。重要的是,最近一项临床研究证实,长时间的机械通气会导致人体膈肌萎缩。这种机械通气引起的膈肌无力很重要,因为脱机困难最常见的原因是由于吸气肌无力和/或吸气肌耐力下降导致的呼吸肌无力。因此,开发预防机械通气引起的膈肌无力的方法很重要。