Observational studyCritical care (London, England)2024
Dyssynchronous diaphragm contractions impair diaphragm function in mechanically ventilated patients.
Observational study in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03108118 (Diaphragm Injury and Dysfunction During Mechanical Ventilation), which is not on this map. Cited by 11 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.
Diaphragm Injury and Dysfunction During Mechanical Ventilation
Who cites it
11 citing papers in PubMed, 21 citations in OpenAlex.
- VIDD or CIADD? The ventilator remains a bona fide culprit.BMC anesthesiology · 2026Article
- Lung- and diaphragm-protective mechanical ventilation in acute respiratory distress syndrome.Intensive care medicine · 2026Review
- 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
- Patient-ventilator asynchrony: physiological causes and clinical aspects.Intensive care medicine · 2026Article
- Diaphragm physiological similarity index (DPSI): a de Novo speckle-tracking ultrasound metric for HFNC adjustment in acute respiratory failure.Critical care (London, England) · 2026Article
- Ventilator-induced diaphragmatic dysfunction: pathophysiology, monitoring and advances in potential treatment and prevention.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Debate on the Role of Eccentric Contraction of the Diaphragm: Is It Always Harmful?Healthcare (Basel, Switzerland) · 2025Article
- Advances in Machine Learning for Mechanically Ventilated Patients.International journal of general medicine · 2025Review
- Post-insufflation diaphragm contractions in patients receiving various modes of mechanical ventilation.Critical care (London, England) · 2024Article
- Volatile anesthetics for lung- and diaphragm-protective sedation.Critical care (London, England) · 2024Review
- Implementing diaphragm protection during invasive mechanical ventilation.Intensive care medicine · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundPre-clinical studies suggest that dyssynchronous diaphragm contractions during mechanical ventilation may cause acute diaphragm dysfunction. We aimed to describe the variability in diaphragm contractile loading conditions during mechanical ventilation and to establish whether dyssynchronous diaphragm contractions are associated with the development of impaired diaphragm dysfunction.
methodsIn patients receiving invasive mechanical ventilation for pneumonia, septic shock, acute respiratory distress syndrome, or acute brain injury, airway flow and pressure and diaphragm electrical activity (Edi) were recorded hourly around the clock for up to 7 days. Dyssynchronous post-inspiratory diaphragm loading was defined based on the duration of neural inspiration after expiratory cycling of the ventilator. Diaphragm function was assessed on a daily basis by neuromuscular coupling (NMC, the ratio of transdiaphragmatic pressure to diaphragm electrical activity).
resultsA total of 4508 hourly recordings were collected in 45 patients. Edi was low or absent (≤ 5 µV) in 51% of study hours (median 71 h per patient, interquartile range 39-101 h). Dyssynchronous post-inspiratory loading was present in 13% of study hours (median 7 h per patient, interquartile range 2-22 h). The probability of dyssynchronous post-inspiratory loading was increased with reverse triggering (odds ratio 15, 95% CI 8-35) and premature cycling (odds ratio 8, 95% CI 6-10). The duration and magnitude of dyssynchronous post-inspiratory loading were associated with a progressive decline in diaphragm NMC (p < 0.01 for interaction with time).
conclusionsDyssynchronous diaphragm contractions may impair diaphragm function during mechanical ventilation.
trial registrationMYOTRAUMA, ClinicalTrials.gov NCT03108118. Registered 04 April 2017 (retrospectively registered).
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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.