Stručni rad
CAN WE REVERSE NEGATIVE IMPACT OF PROLONGED MECHANICAL VENTILATION ON RESPIRATORY MUSCLES?
Luka Camlek
; Klinika za plućne i alergološke bolesti Golnik
Sažetak
BACKGROUND: Prolonged mechanical ventilation
although saving lives, can have decremental eff ect on repiratory
muscles, mainly diaphragm. Th e aim of this article
is to summarize the mechanisms of respiratory muscle
atrophy and possible interventions for atrophy reversal.Discussion
Systematic literature review.
CONCLUSIONS: Intensive care unit physicians are aware
of negative impact of nechanical ventilation on lung parenchyma.
But recently more and more evidence is accumulating,
that mechanical ventilation provides isuffi cient stress
on respiratory muscles and with that promoting diaphragm
atrophy and contractile dysfunction which leads to
prolonged weaning and ventilator dependency. Research
on animals has documented that inactivity of diaphragm
induces injury and atrophy of muscle cells. Studies on
patients on controlled mechanical mentilation confi rmed
this phenomena in humans. Th e mechanisms of diaphragm
atrophy are complex an include oxidative injury,
decreased protein turnover, gene expresson and cell signaling,
and induction of diaphragm muscle cell apoptosis.
Diaphragm atrophy and dysfunction leads to prolonged
mechanical ventilation, ventilator dependency and also to
increased mortality.
Th is phenomena can be in some patients reversed with respiratory
muscle training. Th e results between studies vary,
mainly beacuse in they used diff erent methods of respiratory
muscle training, and included the patients with diff erent
diseases. Future studies will show which patients will
have the greatest benefi t from respiratory muscle trainig and
which trainig regime is best for muscle growth induction.
Ključne riječi
diaphragm; respiratory muscles; mechanical ventilation; diaphragm weakness; inspiratory muscle training; respiratory physiotherapy
Hrčak ID:
174010
URI
Datum izdavanja:
19.10.2016.
Posjeta: 727 *