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INTRODUCTION

This narrative review summarizes current knowledge on the physiology and pathophysiology of expiratory muscle function in ICU patients, as shared by academic professionals from multidisciplinary, multinational backgrounds, who include clinicians, clinical physiologists and basic physiologists.

RESULTS

The expiratory muscles, which include the abdominal wall muscles and some of the rib cage muscles, are an important component of the respiratory muscle pump and are recruited in the presence of high respiratory load or low inspiratory muscle capacity. Recruitment of the expiratory muscles may have beneficial effects, including reduction in end-expiratory lung volume, reduction in transpulmonary pressure and increased inspiratory muscle capacity. However, severe weakness of the expiratory muscles may develop in ICU patients and is associated with worse outcomes, including difficult ventilator weaning and impaired airway clearance. Several techniques are available to assess expiratory muscle function in the critically ill patient, including gastric pressure and ultrasound.

CONCLUSION

The expiratory muscles are the "neglected component" of the respiratory muscle pump. Expiratory muscles are frequently recruited in critically ill ventilated patients, but a fundamental understanding of expiratory muscle function is still lacking in these patients.

INTRODUCTION

RESULTS

CONCLUSION

简介

本文是一篇叙事综述，总结了来自多学科、跨国背景的学术专业人士（包括临床医生、临床生理学家和基础生理学家）对 ICU 患者呼气肌功能的生理学和病理生理学的现有认识。

结果

呼气肌包括腹壁肌和部分肋骨间肌，是呼吸肌泵的重要组成部分，在呼吸负荷高或吸气肌能力低时被募集。呼气肌的募集可能具有有益的效果，包括降低呼气末肺容积、降低跨肺压和增加吸气肌能力。然而，ICU 患者可能会出现严重的呼气肌无力，与更差的预后相关，包括呼吸机撤离困难和气道清除受损。有几种技术可用于评估危重症患者的呼气肌功能，包括胃内压和超声。