Ewan C Goligher, Martin Dres, Bhakti K Patel, Sarina K Sahetya, Jeremy R Beitler, Irene Telias, Takeshi Yoshida, Katerina Vaporidi, Domenico Luca Grieco, Tom Schepens, Giacomo Grasselli, Savino Spadaro, Jose Dianti, Marcelo Amato, Giacomo Bellani, Alexandre Demoule, Eddy Fan, Niall D Ferguson, Dimitrios Georgopoulos, Claude Guérin, Robinder G Khemani, Franco Laghi, Alain Mercat, Francesco Mojoli, Coen A C Ottenheijm, Samir Jaber, Leo Heunks, Jordi Mancebo, Tommaso Mauri, Antonio Pesenti, Laurent Brochard
Mechanical ventilation can cause acute diaphragm atrophy and injury, and this is associated with poor clinical outcomes. Although the importance and impact of lung-protective ventilation is widely appreciated and well established, the concept of diaphragm-protective ventilation has recently emerged as a potential complementary therapeutic strategy. This Perspective, developed from discussions at a meeting of international experts convened by PLUG (the Pleural Pressure Working Group) of the European Society of Intensive Care Medicine, outlines a conceptual framework for an integrated lung- and diaphragm-protective approach to mechanical ventilation on the basis of growing evidence about mechanisms of injury...
October 1, 2020: American Journal of Respiratory and Critical Care Medicine