ReviewEuropean respiratory review : an official journal of the European Respiratory Society2025
Ventilator-induced diaphragmatic dysfunction: pathophysiology, monitoring and advances in potential treatment and prevention.
Review in European respiratory review : an official journal of the European Respiratory Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers, 4 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Association Between Diaphragm Ultrasound Measures and Extubation Outcomes in Neonates: A Systematic Review and Meta-Analysis.Pediatric pulmonology · 2026Pooled it
- Predictive value of diaphragmatic ultrasound for weaning outcomes in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis.Critical care (London, England) · 2026Pooled it
- The effect of respiratory training on lung function in intensive care unit patients: a systematic review and meta-analysis.BMC pulmonary medicine · 2026Pooled it
- Risk factors for diaphragmatic dysfunction in mechanically ventilated patients: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- VIDD or CIADD? The ventilator remains a bona fide culprit.BMC anesthesiology · 2026Article
- Phenotype-based modeling of postoperative ventilatory liberation failure: A dynamic mechanistic framework for precision perioperative medicine.Journal of anesthesia and translational medicine · 2026Review
- Enhancing patient safety: factors influencing critical care nurses' intravenous sedation practices in mechanically ventilated patients.BMC nursing · 2026Article
- Assessment of the role of inflammation-linked signaling pathways in ventilator-induced diaphragmatic dysfunction in rats by transcriptome RNA-seq.BMC molecular and cell biology · 2026Article
- Targeting the diaphragm during weaning from mechanical ventilation.Journal of thoracic disease · 2026Article
- Effects of Phrenic Nerve Stimulation in Mechanically Ventilated Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of clinical medicine · 2026Review
- Sepsis Dysregulates Mitochondrial microRNA and Biogenesis in the Diaphragm but Not Limb Muscle.International journal of molecular sciences · 2026Article
- Rehabilitating the diaphragm: an integrated approach to intensive care unit-acquired dysfunction in critical illness-a narrative review.Acute and critical care · 2026Article
- The contribution of mechanical ventilation to critical illness-associated diaphragm dysfunction: a critical appraisal.Critical care (London, England) · 2026Review
- Application of bedside ultrasound assessment of diaphragmatic function in preparing tracheostomised patients for ventilator liberation and decannulation: a narrative review.Journal of thoracic disease · 2026Review
- Patient Self-Inflicted Lung Injury in ARDS: From Physiological Concept to Clinical Syndrome.Journal of clinical medicine · 2026Review
- Physiology-guided personalized mechanical ventilation to prevent ventilator-induced lung injury.Frontiers in medicine · 2026Review
- Identification of competing endogenous RNA networks involved in phrenic nerve stimulation preventing mechanical ventilation induced diaphragm dysfunction.Scientific reports · 2025Article
- Nursing-based precision assessment of nutrition and muscle status without ultrasound: a prospective observational study in mechanically ventilated neurosurgical patients.Frontiers in medicine · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Mechanical ventilation is a life-saving method for those critically ill patients with acute or chronic respiratory failure without assistance. However, even short-term mechanical ventilation can lead to alterations in the fibrous structure and reduced contraction force of the diaphragm, which is defined as ventilator-induced diaphragmatic dysfunction (VIDD). This condition is associated with various risks of adverse clinical outcomes. Research on mechanical ventilation-related respiratory mechanics helps us to understand the macroscopic myotrauma mechanisms of VIDD. Ongoing clinical trials into comprehensive management strategies for lung- and diaphragm-protective ventilation are continually refining respiratory therapy protocols in clinical practice. Although the cellular and molecular mechanisms are not fully defined, pathways involving mitochondrial oxidative stress have been identified as key contributors to disease progression, leading to both accelerated proteolysis and depressed protein synthesis. Additionally, research on the ubiquitin-proteasome pathway, lysosomal autophagy, calpain, caspase-3 and dysfunction of the ryanodine receptor-1 pathway is enhancing our understanding of the downstream mechanisms involved. Promising interventions based on these findings have yielded hopeful results in animal models for preventing VIDD. This review summarises the epidemiology and pathophysiological mechanisms of VIDD and advances in potential treatment and prevention.
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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.