ArticleIntensive care medicine2019
Structural differences in the diaphragm of patients following controlled vs assisted and spontaneous mechanical ventilation.
Article in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07172061 (Sigh in Pressure Support Ventilation to Detect Respiratory System Compliance and Lung Recruitability), which is not on this map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Sigh in Pressure Support Ventilation to Detect Respiratory System Compliance and Lung Recruitability
Who cites it
15 citing papers in PubMed, 39 citations in OpenAlex.
- Awake vs. Sedated Cannulation for Extra-Corporeal Membrane Oxygenation in Patients with COVID-19 Induced Acute Respiratory Distress Syndrome.Journal of clinical medicine · 2026Article
- The invasive and non-invasive monitoring of inspiratory effort and drive during assisted mechanical ventilation.Annals of intensive care · 2026Review
- Multimodal diaphragmatic ultrasound indicators in healthy adults: reliability and consistency observation by ultrasound physician and critical care physician.Frontiers in medicine · 2025Article
- Diaphragm Function in Health and Disease.Advances in experimental medicine and biology · 2025Review
- Association of diaphragmatic dysfunction with duration of mechanical ventilation in patients in the pediatric intensive care unit: a prospective cohort study.BMC pediatrics · 2024Article
- Individual response in patient's effort and driving pressure to variations in assistance during pressure support ventilation.Annals of intensive care · 2023Article
- Effect and mechanical mechanism of spontaneous breathing on oxygenation and lung injury in mild or moderate animal ARDS.BMC pulmonary medicine · 2023Article
- Evaluation of IntelliVent-ASV® and PS-SIMV Mode Using Ultrasound (US) Measurements in Terms of Diaphragm Atrophy.Cureus · 2023Article
- Diaphragm Ultrasound in Critically Ill Patients on Mechanical Ventilation-Evolving Concepts.Diagnostics (Basel, Switzerland) · 2023Review
- Association between histological diaphragm atrophy and ultrasound diaphragm expiratory thickness in ventilated patients.Journal of intensive care · 2022Article
- Radical resection of solitary tracheal extramedullary plasmacytoma under non-intubated anesthesia: a case report.Annals of translational medicine · 2021Article
- Tubeless video-assisted thoracoscopic surgery in mediastinal tumor resection.Gland surgery · 2021Article
- Oxygen administration for patients with ARDS.Journal of intensive care · 2021Review
- Respiratory muscle senescence in ageing and chronic lung diseases.European respiratory review : an official journal of the European Respiratory Society · 2020Article
- Assisted mechanical ventilation promotes recovery of diaphragmatic thickness in critically ill patients: a prospective observational study.Critical care (London, England) · 2020Observational
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeVentilator-induced diaphragm dysfunction or damage (VIDD) is highly prevalent in patients under mechanical ventilation (MV), but its analysis is limited by the difficulty of obtaining histological samples. In this study we compared diaphragm histological characteristics in Maastricht III (MSIII) and brain-dead (BD) organ donors and in control subjects undergoing thoracic surgery (CTL) after a period of either controlled or spontaneous MV (CMV or SMV).
methodsIn this prospective study, biopsies were obtained from diaphragm and quadriceps. Demographic variables, comorbidities, severity on admission, treatment, and ventilatory variables were evaluated. Immunohistochemical analysis (fiber size and type percentages) and quantification of abnormal fibers (a surrogate of muscle damage) were performed.
resultsMuscle samples were obtained from 35 patients. MSIII (n = 16) had more hours on MV (either CMV or SMV) than BD (n = 14) and also spent more hours and a greater percentage of time with diaphragm stimuli (time in assisted and spontaneous modalities). Cross-sectional area (CSA) was significantly reduced in the diaphragm and quadriceps in both groups in comparison with CTL (n = 5). Quadriceps CSA was significantly decreased in MSIII compared to BD but there were no differences in the diaphragm CSA between the two groups. Those MSIII who spent 100 h or more without diaphragm stimuli presented reduced diaphragm CSA without changes in their quadriceps CSA. The proportion of internal nuclei in MSIII diaphragms tended to be higher than in BD diaphragms, and their proportion of lipofuscin deposits tended to be lower, though there were no differences in the quadriceps fiber evaluation.
conclusionsThis study provides the first evidence in humans regarding the effects of different modes of MV (controlled, assisted, and spontaneous) on diaphragm myofiber damage, and shows that diaphragm inactivity during mechanical ventilation is associated with the development of VIDD.
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