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Diaphragmatic atrophy

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https://www.readbyqxmd.com/read/27798315/detection-of-ventilator-autotriggering-by-an-esophageal-catheter-used-to-monitor-the-neural-input-and-diaphragm-excitation
#1
Harbaksh Sangha, Troy Whitacre
Patient-ventilator synchrony has been the focus of attention in the field of mechanical ventilation for quite some time now. Toward that end, the modern ventilators are equipped with very sensitive pneumatic triggering mechanisms, which allow for minimal wasting of patient effort. The increasingly sensitive pneumatic triggers have the potential to cause autotriggering, where stimuli other than neural signals (eg, cardiac oscillations) can trigger the mechanical breath. Although autotriggering has been well documented in brain-dead patients, its existence is difficult to prove in patients who have the ability to trigger breath through neural diaphragmatic activity...
October 25, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27766377/-diaphragm-dysfunction-facts-for-clinicians
#2
C S Bruells, G Marx
Diaphragm function is crucial for patient outcome in the ICU setting and during the treatment period. The occurrence of an insufficiency of the respiratory pump, which is predominantly formed by the diaphragm, may result in intubation after failure of noninvasive ventilation. Especially patients suffering from chronic obstructive pulmonary disease are in danger of hypercapnic respiratory failure. Changes in biomechanical properties and fiber texture of the diaphragm are further cofactors directly leading to a need for intubation and mechanical ventilation...
October 20, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27673044/poster-285-ultrasound-guided-diaphragmatic-emg-in-patient-with-respiratory-decline-and-pre-existing-contralateral-diaphragm-atrophy-a-case-report
#3
Benjamin J Bonte, Jason Freeman, Gary Fang, Harald Sauthoff
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27620292/assessment-of-diaphragmatic-dysfunction-in-the-critically-ill-patient-with-ultrasound-a-systematic-review
#4
Massimo Zambon, Massimiliano Greco, Speranza Bocchino, Luca Cabrini, Paolo Federico Beccaria, Alberto Zangrillo
PURPOSE: Diaphragmatic dysfunction (DD) has a high incidence in critically ill patients and is an under-recognized cause of respiratory failure and prolonged weaning from mechanical ventilation. Among different methods to assess diaphragmatic function, diaphragm ultrasonography (DU) is noninvasive, rapid, and easy to perform at the bedside. We systematically reviewed the current literature assessing the usefulness and accuracy of DU in intensive care unit (ICU) patients. METHODS: Pubmed, Cochrane Database of Systematic Reviews, Embase, Scopus, and Google Scholar Databases were searched for pertinent studies...
September 12, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27570397/spinal-muscular-atrophy-with-respiratory-distress-syndrome-smard1-case-report-and-review-of-literature
#5
Lokesh Lingappa, Nikit Shah, Ananth Sagar Motepalli, Farhan Shaik
Spinal muscular atrophy with respiratory distress syndrome (SMARD1) is a rare cause of early infantile respiratory failure and death. No cases have been currently described from India. Two low-birth-weight infants presented prior to 6 months of age with recurrent apnea and respiratory distress. Both required prolonged ventilation, and had distal arthrogryposis and diaphragmatic eventration. Nerve conduction study revealed motor sensory axonopathy. Genetic testing confirmed mutations in immunoglobulin mu binding protein (IGHMBP2)...
July 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27553431/diaphragm-dysfunction-in-mechanically-ventilated-patients
#6
Irene Dot, Purificación Pérez-Teran, Manuel-Andrés Samper, Joan-Ramon Masclans
Muscle involvement is found in most critical patients admitted to the intensive care unit (ICU). Diaphragmatic muscle alteration, initially included in this category, has been differentiated in recent years, and a specific type of muscular dysfunction has been shown to occur in patients undergoing mechanical ventilation. We found this muscle dysfunction to appear in this subgroup of patients shortly after the start of mechanical ventilation, observing it to be mainly associated with certain control modes, and also with sepsis and/or multi-organ failure...
August 20, 2016: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/27532030/prolonged-glucocorticoid-treatment-in-ards-impact-on-intensive-care-unit-acquired-weakness
#7
REVIEW
Gianfranco Umberto Meduri, Andreas Schwingshackl, Greet Hermans
Systemic inflammation and duration of immobilization are strong independent risk factors for the development of intensive care unit-acquired weakness (ICUAW). Activation of the pro-inflammatory transcription factor nuclear factor-κB (NF-κB) results in muscle wasting during disuse-induced skeletal muscle atrophy (ICU bed rest) and septic shock. In addition, NF-κB-mediated signaling plays a significant role in mechanical ventilation-induced diaphragmatic atrophy and contractile dysfunction. Older trials investigating high dose glucocorticoid treatment reported a lack of a sustained anti-inflammatory effects and an association with ICUAW...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27515219/renin-angiotensin-system-in-ventilator-induced-diaphragmatic-dysfunction-potential-protective-role-of-angiotensin-1-7
#8
Anna Sigurta', Vanessa Zambelli, Giacomo Bellani
Ventilator-induced diaphragmatic dysfunction is a feared complication of mechanical ventilation that adversely affects the outcome of intensive care patients. Human and animal studies demonstrate atrophy and ultrastructural alteration of diaphragmatic muscular fibers attributable to increased oxidative stress, depression of the anabolic pathway regulated by Insulin-like growing factor 1 and increased proteolysis. The renin-angiotensin system, through its main peptide Angiotensin II, plays a major role in skeletal muscle diseases, mainly increasing oxidative stress and inducing insulin resistance, atrophy and fibrosis...
September 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27469131/diaphragmatic-eventration-in-sisters-with-asparagine-synthetase-deficiency-a-novel-homozygous-asns-mutation-and-expanded-phenotype
#9
Jun Sun, Angela J McGillivray, Jason Pinner, Zhihui Yan, Fengxia Liu, Drago Bratkovic, Elizabeth Thompson, Xiuxiu Wei, Huifeng Jiang, Asan, Maya Chopra
BACKGROUND: Asparagine Synthetase Deficiency (ASNSD; OMIM #615574) is a newly described rare autosomal recessive neurometabolic disorder, characterised by congenital microcephaly, severe psychomotor delay, encephalopathy and progressive cerebral atrophy. To date, seven families and seven missense mutations in the ASNSD disease causing gene, ASNS, have been published. METHODS: We report two further affected infant sisters from a consanguineous Indian family, who in addition to the previously described features had diaphragmatic eventration...
July 27, 2016: JIMD Reports
https://www.readbyqxmd.com/read/27457930/leaky-ryanodine-receptors-contribute-to-diaphragmatic-weakness-during-mechanical-ventilation
#10
Stefan Matecki, Haikel Dridi, Boris Jung, Nathalie Saint, Steven R Reiken, Valérie Scheuermann, Ségolène Mrozek, Gaetano Santulli, Alisa Umanskaya, Basil J Petrof, Samir Jaber, Andrew R Marks, Alain Lacampagne
Ventilator-induced diaphragmatic dysfunction (VIDD) refers to the diaphragm muscle weakness that occurs following prolonged controlled mechanical ventilation (MV). The presence of VIDD impedes recovery from respiratory failure. However, the pathophysiological mechanisms accounting for VIDD are still not fully understood. Here, we show in human subjects and a mouse model of VIDD that MV is associated with rapid remodeling of the sarcoplasmic reticulum (SR) Ca(2+) release channel/ryanodine receptor (RyR1) in the diaphragm...
August 9, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27175808/vats-diaphragm-plication
#11
Mohamed Moneer ElSaegh, Nur Ismail, Joel Dunning
Elevated diaphragm can be due to diaphragmatic eventration or diaphragm paralysis. Diaphragm paralysis is a rare condition that can be congenital or acquired. Acquired diaphragmatic paralysis can result from injury to the phrenic nerve. Subsequently, there is loss of contractility of the diaphragm muscle leading to progressive atrophy and, hence, distension of the dome of the diaphragm leading to elevated right, left, or both copula of the diaphragm. Diaphragm plication aims to return the abdominal contents back to their normal position and allow for greater lung expansion by reducing the abundant diaphragmatic surface...
April 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27066569/recessive-reep1-mutation-is-associated-with-congenital-axonal-neuropathy-and-diaphragmatic-palsy
#12
Gudrun Schottmann, Dominik Seelow, Franziska Seifert, Susanne Morales-Gonzalez, Esther Gill, Katja von Au, Arpad von Moers, Werner Stenzel, Markus Schuelke
OBJECTIVE: To identify the underlying genetic cause of a congenital neuropathy in a 5-year-old boy as part of a cohort of 32 patients from 23 families with genetically unresolved neuropathies. METHODS: We used autozygosity mapping coupled with next-generation sequencing to investigate a consanguineous family from Lebanon with 1 affected and 2 healthy children. Variants were investigated for segregation in the family by Sanger sequencing. A splice site mutation was further evaluated on the messenger RNA level by quantitative reverse transcription PCR...
December 2015: Neurology. Genetics
https://www.readbyqxmd.com/read/27055225/inhibition-of-src-and-forkhead-box-o1-signaling-by-induced-pluripotent-stem-cell-therapy-attenuates-hyperoxia-augmented-ventilator-induced-diaphragm-dysfunction
#13
Li-Fu Li, Yuh-Lih Chang, Ning-Hung Chen, Chien-Ying Wang, Gwo-Jyh Chang, Meng-Chih Lin, Chih-Hao Chang, Chung-Chi Huang, Jen-Hua Chuang, Yi-Pin Yang, Shih-Hwa Chiou, Yung-Yang Liu
Mechanical ventilation (MV) with hyperoxia is required for providing life support to patients with acute lung injury (ALI). However, MV may cause diaphragm weakness through muscle injury and atrophy, an effect termed ventilator-induced diaphragm dysfunction (VIDD). Src protein tyrosine kinase and class O of forkhead box 1 (FoxO1) mediate acute inflammatory responses and muscle protein degradation induced by oxidative stress. Induced pluripotent stem cells (iPSCs) have been reported to improve hyperoxia-augmented ALI; however, the mechanisms regulating the interactions among VIDD, hyperoxia, and iPSCs are unclear...
July 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/27030815/dysfunction-of-respiratory-muscles-in-critically-ill-patients-on-the-intensive-care-unit
#14
REVIEW
David Berger, Stefan Bloechlinger, Stephan von Haehling, Wolfram Doehner, Jukka Takala, Werner J Z'Graggen, Joerg C Schefold
Muscular weakness and muscle wasting may often be observed in critically ill patients on intensive care units (ICUs) and may present as failure to wean from mechanical ventilation. Importantly, mounting data demonstrate that mechanical ventilation itself may induce progressive dysfunction of the main respiratory muscle, i.e. the diaphragm. The respective condition was termed 'ventilator-induced diaphragmatic dysfunction' (VIDD) and should be distinguished from peripheral muscular weakness as observed in 'ICU-acquired weakness (ICU-AW)'...
September 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/26992064/mechanical-ventilation-and-diaphragmatic-atrophy-in-critically-ill-patients-an-ultrasound-study
#15
Massimo Zambon, Paolo Beccaria, Jun Matsuno, Marco Gemma, Elena Frati, Sergio Colombo, Luca Cabrini, Giovanni Landoni, Alberto Zangrillo
OBJECTIVE: Mechanical ventilation contributes to diaphragmatic atrophy and dysfunction, and few techniques exist to assess diaphragmatic function: the purpose of this study was to quantify diaphragm atrophy in a population of critically ill mechanically ventilated patients with ultrasound and to identify risk factors that can worsen diaphragmatic activity. DESIGN: Prospective observational study. SETTING: ICU of a 1,200-bed university hospital...
July 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26922252/infantile-spinal-muscular-atrophy-with-respiratory-distress-type-i-presenting-without-respiratory-involvement-novel-mutations-and-review-of-the-literature
#16
Xinghua Luan, Xiaojun Huang, Xiaoli Liu, Haiyan Zhou, Shengdi Chen, Li Cao
Spinal muscular atrophy with respiratory distress type 1 (SMARD1), also known as distal spinal muscular atrophy 1 (DSMA1) or distal hereditary motor neuropathies type 6 (dHMN6), is a rare autosomal recessive motor neuron disorder that affects infants and is characterized by diaphragmatic palsy, distal muscular weakness and muscle atrophy. The disease is caused by mutations in the gene encoding immunoglobulinm-binding protein 2 (IGHMBP2). We present a female child with novel compound heterozygous mutations in IGHMBP2 gene c...
August 2016: Brain & Development
https://www.readbyqxmd.com/read/26849371/blockage-of-the-ryanodine-receptor-via-azumolene-does-not-prevent-mechanical-ventilation-induced-diaphragm-atrophy
#17
Erin E Talbert, Ashley J Smuder, Oh Sung Kwon, Kurt J Sollanek, Michael P Wiggs, Scott K Powers
Mechanical ventilation (MV) is a life-saving intervention for patients in respiratory failure. However, prolonged MV causes the rapid development of diaphragm muscle atrophy, and diaphragmatic weakness may contribute to difficult weaning from MV. Therefore, developing a therapeutic countermeasure to protect against MV-induced diaphragmatic atrophy is important. MV-induced diaphragm atrophy is due, at least in part, to increased production of reactive oxygen species (ROS) from diaphragm mitochondria and the activation of key muscle proteases (i...
2016: PloS One
https://www.readbyqxmd.com/read/26803697/intramuscular-diaphragmatic-stimulation-for-patients-with-traumatic-high-cervical-injuries-and-ventilator-dependent-respiratory-failure-a-systematic-review-of-safety-and-effectiveness
#18
REVIEW
Bhavin Garara, Alasdair Wood, Hani J Marcus, Kevin Tsang, Mark H Wilson, Mansoor Khan
BACKGROUND: Intramuscular diaphragmatic stimulation using an abdominal laparoscopic approach has been proposed as a safer alternative to traditional phrenic nerve stimulation. It has also been suggested that early implementation of diaphragmatic pacing may prevent diaphragm atrophy and lead to earlier ventilator independence. The aim of this study was therefore to systematically review the safety and effectiveness of intramuscular diaphragmatic stimulators in the treatment of patients with traumatic high cervical injuries resulting in long-term ventilator dependence, with particular emphasis on the affect of timing of insertion of such stimulators...
March 2016: Injury
https://www.readbyqxmd.com/read/26702144/dissecting-the-role-of-the-myofilament-in-diaphragm-dysfunction-during-the-development-of-heart-failure-in-mice
#19
COMPARATIVE STUDY
Todd E Gillis, Jordan M Klaiman, Andrew Foster, Mathew J Platt, Jason S Huber, Melissa Y Corso, Jeremy A Simpson
Dyspnea and reduced exercise capacity, caused, in part, by respiratory muscle dysfunction, are common symptoms in patients with heart failure (HF). However, the etiology of diaphragmatic dysfunction has not been identified. To investigate the effects of HF on diaphragmatic function, models of HF were surgically induced in CD-1 mice by transverse aortic constriction (TAC) and acute myocardial infarction (AMI), respectively. Assessment of myocardial function, isolated diaphragmatic strip function, myofilament force-pCa relationship, and phosphorylation status of myofilament proteins was performed at either 2 or 18 wk postsurgery...
March 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/26639081/the-course-of-diaphragm-atrophy-in-ventilated-patients-assessed-with-ultrasound-a-longitudinal-cohort-study
#20
Tom Schepens, Walter Verbrugghe, Karolien Dams, Bob Corthouts, Paul M Parizel, Philippe G Jorens
INTRODUCTION: Mechanical ventilation and the effect of respiratory muscle unloading on the diaphragm cause ventilator-induced diaphragmatic dysfunction (VIDD). Atrophy of the diaphragmatic muscle is a major part of VIDD, and has a rapid onset in most animal models. We wanted to assess the clinical evolution and risk factors for VIDD in an adult intensive care unit (ICU) by measuring diaphragm thickness using ultrasound. METHOD: We performed a single-centre observational cohort study, including 54 mechanically ventilated patients...
December 7, 2015: Critical Care: the Official Journal of the Critical Care Forum
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