https://www.resmedjournal.com/article/S0954-6111(24)00015-5/fulltext?rss=yes

Ventilator-induced diaphragm dysfunction:

• A review of this phenomenon gaining recognition in both research and clinical practice
• Noninvasive methods, such as transthoracic diaphragm ultrasound, and the gold standard transdiaphragmatic pressure recordings for assessing diaphragm function

Diaphragm anatomy, innervation, and function:

• Description of diaphragm structure, muscle fibers, and innervation by phrenic nerves
• Explanation of diaphragm's role in inspiration and quantification of its force through transdiaphragmatic pressure

Evidence for VIDD:

• Animal studies showing a decline in diaphragmatic force-generating capacity and endurance during mechanical ventilation
• Histological evidence and molecular mechanisms contributing to diaphragm muscle fiber changes associated with VIDD

Prevalence and impact of VIDD:

• Prevalence of diaphragm dysfunction ranging from 25% to 63% during liberation from mechanical ventilation
• Link between ventilator driving pressure, contractile activity, and risk of VIDD

Strategies for prevention and management:

• Importance of diaphragm-protective ventilation strategies
• Potential of diaphragm neurostimulation as a novel treatment option

Clinical implications of VIDD:

• VIDD as a significant contributor to prolonged or unsuccessful liberation from mechanical ventilation
• Complications and impact of mechanical ventilation on diaphragm function

Initiation and impact of mechanical ventilation: