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[危重症成年患者有创机械通气相关的膈肌功能障碍]

[Diaphragmatic dysfunction associated with invasive mechanical ventilation in critically ill adult patients].

作者信息

Tocalini Pablo, Vicente Antonela, Carballo Juan Manuel, Garegnani Luis Ignacio

机构信息

Clínica Basilea, Solís 1025, C1078, CABA, Argentina..

Hospital General de Agudos Parmenio Piñero, Av. Varela 1301, CP1406, CABA, Argentina..

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2021 Jun 28;78(2):197-206. doi: 10.31053/1853.0605.v78.n2.28458.

Abstract

Invasive mechanical ventilation (VMI) is a life support therapy that is not free of complications, such as ventilator induced diaphragmatic dysfunction, which is characterized by atrophy and weakness of the muscle. Interest in this pathology seems to be based on the association found with negative clinical results. The prevalence ranges between 29 and 80%, probably due to the variability between the different diagnostic methods and the time of evaluation. The gold standard continues to be the transdiaphragmatic negative pressure generated by the bilateral stimulation of the phrenic nerves, although due to the lack of practicality, diaphragmatic ultrasound began to be used. Although it has several modalities, not all of them have correlation analysis with the gold standard. Another problem arises when analyzing the independent association between pathology and VMI, since confusing factors are not easy to isolate.

摘要

有创机械通气(VMI)是一种并非没有并发症的生命支持疗法,例如呼吸机诱发的膈肌功能障碍,其特征是肌肉萎缩和无力。对这种病理状况的关注似乎基于所发现的与负面临床结果的关联。患病率在29%至80%之间,这可能是由于不同诊断方法和评估时间的差异所致。尽管由于缺乏实用性,膈超声开始被使用,但金标准仍然是双侧刺激膈神经产生的跨膈负压。虽然它有多种方式,但并非所有方式都与金标准有相关性分析。在分析病理状况与VMI之间的独立关联时还会出现另一个问题,因为混杂因素不容易分离。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bad/8741307/f9f96ff71bc7/1853-0605-78-2-197-gf001.jpg

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