ReviewIntensive care medicine2019
Expiratory muscle dysfunction in critically ill patients: towards improved understanding.
Review 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 4 registered trials, which are not on this map. Cited by 50 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Muscle Recruitment During Neck Flexion and Inspiratory Muscle Training in Difficult and Prolonged Weaning Patients: a Physiological Study - The FLEX Study
The Development of Post-operative Respiratory Muscle Dysfunction in Neurosurgical Patients
Automated Detection of Patient Ventilator Asynchrony Using Pes Signal A Feasibility Study Towards a Detection Algorithm
Investigation of Posture, Core Stabilization, Respiratory Muscle Strength and Function, and Quality of Life in Women With Urinary Incontinence
Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Acquisition of respiratory surface EMG: a systematic literature review of electrode configurations and methodological reporting.Critical care (London, England) · 2025Pooled it
- Reliability and validity of ultrasonography in evaluating the thickness, excursion, stiffness, and strain rate of respiratory muscles in non-hospitalized individuals: a systematic review.BMC oral health · 2023Pooled it
- Efficacy of Physiotherapy Interventions on Weaning in Mechanically Ventilated Critically Ill Patients: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Influence of ventilatory settings on pendelluft and expiratory muscle activity in hypoxemic patients resuming spontaneous breathing.Critical care (London, England) · 2025Trial
- Breath-synchronized electrical stimulation of the expiratory muscles in mechanically ventilated patients: a randomized controlled feasibility study and pooled analysis.Critical care (London, England) · 2020Trial
- Effects of levosimendan on respiratory muscle function in patients weaning from mechanical ventilation.Intensive care medicine · 2019Trial
- Impact of Frailty and Diaphragmatic Dysfunction on Outcomes in ARDS: Focusing on Perioperative Respiratory Management.The clinical respiratory journal · 2026Article
- Association between abdominal muscle weakness and weaning failure in mechanically ventilated critically ill patients: an ultrasound assessment.Journal of anesthesia, analgesia and critical care · 2026Article
- Magnitude and pattern of breathing effort during spontaneous breathing trials after cardiac surgery: a physiological model of sustained breathing effort despite diaphragm dysfunction.Critical care (London, England) · 2026Article
- Article
- Ultrasound assessment of abdominal respiratory muscles during ventilator weaning: A scoping review.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2026Review
- Monitoring of invasive assisted mechanical ventilation: a good clinical practice document by the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI).Journal of anesthesia, analgesia and critical care · 2025Review
- Assessing inspiratory drive and effort in critically ill patients at the bedside.Critical care (London, England) · 2025Review
- Let's get in sync: current standing and future of AI-based detection of patient-ventilator asynchrony.Intensive care medicine experimental · 2025Review
- Ultrasound-based abdominal muscles and diaphragm assessment in predicting extubation failure in patients requiring neurointensive care: a single-center observational study.Scientific reports · 2025Observational
- The investigation of ultrasound to assess lateral abdominal wall activation with different types of core exercises.BMC sports science, medicine & rehabilitation · 2024Article
- Ventilator Waveforms May Give Clues to Expiratory Muscle Activity.American journal of respiratory and critical care medicine · 2024Article
- Neuromuscular Blockade Improves Results in Acute Respiratory Distress Syndrome: A Mechanism May Be Prevention of Expiratory Muscle Activity, Which Allows More Lung Expansion.American journal of respiratory and critical care medicine · 2024Article
- Analysis and applications of respiratory surface EMG: report of a round table meeting.Critical care (London, England) · 2024Review
- Higher protein intake may benefit in patients with prolonged mechanical ventilation.Frontiers in nutrition · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThis narrative review summarizes current knowledge on the physiology and pathophysiology of expiratory muscle function in ICU patients, as shared by academic professionals from multidisciplinary, multinational backgrounds, who include clinicians, clinical physiologists and basic physiologists.
resultsThe expiratory muscles, which include the abdominal wall muscles and some of the rib cage muscles, are an important component of the respiratory muscle pump and are recruited in the presence of high respiratory load or low inspiratory muscle capacity. Recruitment of the expiratory muscles may have beneficial effects, including reduction in end-expiratory lung volume, reduction in transpulmonary pressure and increased inspiratory muscle capacity. However, severe weakness of the expiratory muscles may develop in ICU patients and is associated with worse outcomes, including difficult ventilator weaning and impaired airway clearance. Several techniques are available to assess expiratory muscle function in the critically ill patient, including gastric pressure and ultrasound.
conclusionThe expiratory muscles are the "neglected component" of the respiratory muscle pump. Expiratory muscles are frequently recruited in critically ill ventilated patients, but a fundamental understanding of expiratory muscle function is still lacking in these patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.