Observational studyCritical care (London, England)2020
Assisted mechanical ventilation promotes recovery of diaphragmatic thickness in critically ill patients: a prospective observational study.
Observational study in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 19 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.
Evolution of Muscle Function, Breathlessness and Quality of Life Following Intra or Extra-Abdominal Sepsis in ICU Patients
Comparison of Two Strategies to Allow Mechanical Ventilation Separation Using Biphasic Airway Pressure Ventilation Without Any Synchronization (BIPAP) or Pressure Support Ventilation (PSV): a Randomized Feasibility Trial
Who cites it
19 citing papers in PubMed, 45 citations in OpenAlex.
- Impact of high-protein enteral nutrition on muscle preservation in mechanically ventilated patients with severe pneumonia: a randomized controlled trial.Journal of health, population, and nutrition · 2024Trial
- Immediate Effect of Mechanical Ventilation Mode and Sedative Infusion on Measured Diaphragm Thickness.Annals of the American Thoracic Society · 2022Trial
- Respiratory Rehabilitation and Decannulation in Adults with Prolonged Mechanical Ventilation After Tracheostomy: A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Article
- Construction and validation of a risk prediction model for early ventilator-induced diaphragm dysfunction in mechanically ventilated patients.Frontiers in medicine · 2026Article
- Role of spontaneous ventilation in diaphragm protection during invasive mechanical ventilation in patients with acute respiratory distress syndrome: a prospective observational study.Critical care science · 2026Observational
- 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
- Diaphragm Morphology and Function in Neurocritical Care Patients: Uncovering Key Correlations With Respiratory Muscle Strength Under Mechanical Ventilation.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2025Observational
- Impact of pressure support ventilation duration after a spontaneous breathing trial on reintubation rates in critically ill subjects: a retrospective study.BMC pulmonary medicine · 2025Article
- Challenges in Transitioning from Controlled to Assisted Ventilation in Acute Respiratory Distress Syndrome (ARDS) Management.Journal of clinical medicine · 2024Article
- Combined cardiac, lung, and diaphragm ultrasound for predicting weaning failure during spontaneous breathing trial.Annals of intensive care · 2024Article
- Early diaphragm dysfunction assessed by ultrasonography after cardiac surgery: a retrospective cohort study.Frontiers in cardiovascular medicine · 2024Article
- Evaluation of IntelliVent-ASV® and PS-SIMV Mode Using Ultrasound (US) Measurements in Terms of Diaphragm Atrophy.Cureus · 2023Article
- Using automatic speckle tracking imaging to measure diaphragm excursion and predict the outcome of mechanical ventilation weaning.Critical care (London, England) · 2023Article
- Diaphragm dysfunction after severe COVID-19: An ultrasound study.Frontiers in medicine · 2022Article
- Comparison of Ultrasound Measurements for Diaphragmatic Mobility, Diaphragmatic Thickness, and Diaphragm Thickening Fraction with Each Other and with Lung Function in Patients with Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary disease · 2022Observational
- COVID-19 ARDS: Points to Be Considered in Mechanical Ventilation and Weaning.Journal of personalized medicine · 2021Review
- Mechanical power normalized to lung-thorax compliance predicts prolonged ventilation weaning failure: a prospective study.BMC pulmonary medicine · 2021Observational
- Duration of diaphragmatic inactivity after endotracheal intubation of critically ill patients.Critical care (London, England) · 2021Observational
Corrections and comments
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Authors and funding
15 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiaphragm atrophy and dysfunction are consequences of mechanical ventilation and are determinants of clinical outcomes. We hypothesize that partial preservation of diaphragm function, such as during assisted modes of ventilation, will restore diaphragm thickness. We also aim to correlate the changes in diaphragm thickness and function to outcomes and clinical factors.
methodsThis is a prospective, multicentre, observational study. Patients mechanically ventilated for more than 48 h in controlled mode and eventually switched to assisted ventilation were enrolled. Diaphragm ultrasound and clinical data collection were performed every 48 h until discharge or death. A threshold of 10% was used to define thinning during controlled and recovery of thickness during assisted ventilation. Patients were also classified based on the level of diaphragm activity during assisted ventilation. We evaluated the association between changes in diaphragm thickness and activity and clinical outcomes and data, such as ventilation parameters.
resultsSixty-two patients ventilated in controlled mode and then switched to the assisted mode of ventilation were enrolled. Diaphragm thickness significantly decreased during controlled ventilation (1.84 ± 0.44 to 1.49 ± 0.37 mm, p < 0.001) and was partially restored during assisted ventilation (1.49 ± 0.37 to 1.75 ± 0.43 mm, p < 0.001). A diaphragm thinning of more than 10% was associated with longer duration of controlled ventilation (10 [5, 15] versus 5 [4, 8.5] days, p = 0.004) and higher PEEP levels (12.6 ± 4 versus 10.4 ± 4 cmH
conclusionMode of ventilation affects diaphragm thickness, and preservation of diaphragmatic contraction, as during assisted modes, can partially reverse the muscle atrophy process. Avoiding a strenuous inspiratory work, as measured by Rapid Shallow Breathing Index and Pressure Muscle Index, may help diaphragm thickness restoration.
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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.