| Title |
Patterns of diaphragm function in critically ill patients receiving prolonged mechanical ventilation: a prospective longitudinal study
|
|---|---|
| Published in |
Annals of Intensive Care, August 2016
|
| DOI | 10.1186/s13613-016-0179-8 |
| Pubmed ID | |
| Authors |
Alexandre Demoule, Nicolas Molinari, Boris Jung, Hélène Prodanovic, Gerald Chanques, Stefan Matecki, Julien Mayaux, Thomas Similowski, Samir Jaber |
| Abstract |
In intensive care unit (ICU) patients, diaphragmatic dysfunction (DD) can occur on admission or during the subsequent stay. The respective incidence of these two phenomena has not been previously studied in humans. The study was designed to describe temporal trends in diaphragm function in mechanically ventilated (MV) patients. Ancillary study of a prospective, 6-month, observational cohort study conducted in two ICUs. MV patients were studied within 24 h following intubation (day-1) and every 48-72 h thereafter. Diaphragm function was assessed by twitch tracheal pressure (Ptr,stim) in response to bilateral anterior magnetic phrenic nerve stimulation. Diaphragm dysfunction was defined as Ptr,stim < 11 cmH2O. Patients who received MV for at least 5 days were retained, and the first and the last measures were analysed. Forty-three patients were included. Overall, 79 % of patients developed DD at some point during their ICU stay: 23 (53 %) patients presented DD on initiation of mechanical ventilation, 14 (33 %) of whom had persistent DD, while diaphragm function improved in 9 (21 %). Among the remaining 20 (47 %) patients who did not present DD on initiation of MV, 11 (26 %) developed DD during the ICU stay, while 9 (21 %) did not. Mortality was higher in patients with DD either on initiation of mechanical ventilation or during the subsequent ICU stay than in those who never developed DD (35 vs. 0 %, p = 0.04). Duration of MV was higher in patients with DD on initiation of MV that subsequently persisted than in patients who never exhibited diaphragm dysfunction (18 vs. 5 days, p = 0.04). Factors associated with a change in Ptr,stim were: age [linear coefficient regression (Coeff.) -0.097, standard error (SD) 0.047, p = 0.046], PaO2/FiO2 ratio (Coeff. 0.014, SD 0.006, p = 0.0211) and the proportion of the time under MV with sedation (per 10 %, Coeff. -5.359, SD 2.451, p = 0.035). DD is observed in a large majority of MV patients ≥5 days at some point of their ICU stay. Various patterns of DD are observed, including DD on initiation of mechanical ventilation and ICU-acquired DD. Trial registration clinicaltrials.gov Identifier # NCT00786526. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Netherlands | 1 | 50% |
| Spain | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 50% |
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 144 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Colombia | 1 | <1% |
| Italy | 1 | <1% |
| Unknown | 142 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 18 | 13% |
| Student > Master | 18 | 13% |
| Student > Ph. D. Student | 15 | 10% |
| Student > Bachelor | 13 | 9% |
| Other | 13 | 9% |
| Other | 31 | 22% |
| Unknown | 36 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 70 | 49% |
| Nursing and Health Professions | 15 | 10% |
| Biochemistry, Genetics and Molecular Biology | 3 | 2% |
| Engineering | 3 | 2% |
| Neuroscience | 2 | 1% |
| Other | 6 | 4% |
| Unknown | 45 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 September 2016.
All research outputs
#13,476,177
of 22,881,964 outputs
Outputs from Annals of Intensive Care
#709
of 1,046 outputs
Outputs of similar age
#201,119
of 366,897 outputs
Outputs of similar age from Annals of Intensive Care
#17
of 33 outputs
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