Mechanical ventilation may alter diaphragm muscle fibers

October 9, 2018

(HealthDay)—In critically ill patients, mechanical ventilation with positive end-expiratory pressure (PEEP) results in reduced diaphragm fiber length that may make it more difficult to wean patients from mechanical ventilation, according to a study published in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

Johan Lindqvist, Ph.D., from the University of Arizona in Tucson, and colleagues studied the structure and function of diaphragm fibers of mechanically ventilated critically ill patients and mechanically ventilated rats with normal and increased titin compliance.

The researchers found that PEEP caused a caudal movement of the diaphragm, both in critically ill patients and in rats; this caudal movement reduced fiber length. In 18-hour mechanically ventilated rats (PEEP of 2.5 cm H2O), diaphragm fibers adapted to the reduced length by absorbing serially linked sarcomeres, the smallest contractile units in muscle (i.e., longitudinal atrophy). Longitudinal atrophy was reduced by increasing the compliance of titin molecules.

"We postulate that longitudinal atrophy, in concert with the aforementioned cross-sectional atrophy, hampers spontaneous breathing trials in : during these efforts, end-expiratory lung volume is reduced, and the shortened diaphragm fibers are stretched to excessive sarcomere lengths," the authors write.

Explore further: Higher positive end-expiratory pressure no benefit in ARDS

More information: Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Related Stories

Higher positive end-expiratory pressure no benefit in ARDS

November 19, 2017
(HealthDay)—For patients with acute respiratory distress syndrome (ARDS), higher positive end-expiratory pressure (PEEP) levels are not likely to improve clinical outcomes, according to a review published in the October ...

Optimal mechanical ventilation strategy identified for obese

May 21, 2015
(HealthDay)—For obese patients, the optimal mechanical ventilation strategy may be volume-controlled ventilation (VCV) with higher positive end-expiratory pressure (PEEP) and single recruitment maneuvers (RMs), according ...

Mechanical ventilation 'no increased risk' of mortality in pregnant patients

October 4, 2018
Researchers in Columbia, South America, conducted a retrospective observational study within six hospitals to identify risk factors of maternal mortality in mechanically ventilated pregnant patients.

Contrary to previous studies, diabetes affects diaphragm, smooth muscle cells differently

August 19, 2015
Previous studies have shown that diabetes adversely affects breathing and respiratory function. However, in the past, researchers have not differentiated diaphragm muscle cells and the muscle cells of limb skeletal muscle ...

Mechanical ventilation associated with long-term disability

May 19, 2015
Critically ill patients who have been mechanically ventilated for more than seven days are at greatly increased risk for functional impairment and mortality at one year following discharge from the intensive care unit (ICU), ...

Recommended for you

Researchers find infectious prions throughout eyes of patients with deadly sporadic Creutzfeldt-Jakob disease

November 20, 2018
By the time symptoms of sporadic Creutzfeldt-Jakob disease (sCJD) are typically discovered, death is looming and inevitable. But, in a new study, researchers at University of California San Diego School of Medicine with colleagues ...

Researchers a step closer to understanding how deadly bird flu virus takes hold in humans

November 19, 2018
New research has taken a step towards understanding how highly pathogenic influenza viruses such as deadly bird flu infect humans.

Infants born to obese mothers risk developing liver disease, obesity

November 16, 2018
Infant gut microbes altered by their mother's obesity can cause inflammation and other major changes within the baby, increasing the risk of obesity and non-alcoholic fatty liver disease later in life, according to researchers ...

New study shows NKT cell subsets play a large role in the advancement of NAFLD

November 16, 2018
Since 2015 it has been known that the gut microbiota could have a direct impact on nonalcoholic fatty liver disease (NAFLD), which affects up to 12% of adults and is a leading cause of chronic liver disease. In the November ...

Antibiotic prescribing influenced by team dynamics within hospitals

November 15, 2018
Antibiotic prescribing by doctors is influenced by team dynamics and cultures within hospitals.

Discovery suggests new route to fight infection, disease

November 14, 2018
New research reveals how a single protein interferes with the immune system when exposed to the bacterium that causes Legionnaires' disease, findings that could have broad implications for development of medicines to fight ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.