Ventilator-Induced Diaphragmatic Dysfunction: Diagnosis and Role of Pharmacological Agents

Respir Care. 2017 Nov;62(11):1485-1491. doi: 10.4187/respcare.05622. Epub 2017 Jul 11.

Abstract

The use of controlled mechanical ventilation results in a major reduction of diaphragmatic contractile force together with atrophy of diaphragm muscle fibers, which is a condition known as ventilator-induced diaphragmatic dysfunction. Ventilator-induced diaphragmatic dysfunction is one of the major contributors to weaning difficulties and even increased mortality. This review summarizes the current data on the pathogenesis and diagnosis of ventilator-induced diaphragmatic dysfunction, and it outlines the use of ultrasonography for diaphragm evaluation. In addition, current pharmacologic agents used to mitigate ventilator-induced diaphragmatic dysfunction are described, with a particular emphasis on the therapeutic potential of theophylline in patients with ventilator-induced diaphragmatic dysfunction-associated weaning difficulties.

Keywords: diaphragm; diaphragm dysfunction; mechanical ventilation; review; theophylline; ultrasonography.

Publication types

  • Review

MeSH terms

  • Bronchodilator Agents / administration & dosage*
  • Diaphragm / diagnostic imaging
  • Diaphragm / injuries
  • Diaphragm / physiopathology*
  • Humans
  • Muscle Contraction / physiology
  • Muscular Diseases / diagnostic imaging
  • Muscular Diseases / drug therapy*
  • Muscular Diseases / etiology
  • Respiration, Artificial / adverse effects*
  • Theophylline / administration & dosage*
  • Ultrasonography / methods
  • Ventilator Weaning / adverse effects*
  • Ventilator Weaning / methods

Substances

  • Bronchodilator Agents
  • Theophylline