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A Trend towards Diaphragmatic Muscle Waste after Invasive Mechanical Ventilation in Multiple Trauma Patients—What to Expect?

Considering the prioritization of life-threatening injuries in trauma care, secondary dysfunctions such as ventilator-induced diaphragmatic dysfunction (VIDD) are often overlooked. VIDD is an entity induced by muscle inactivity during invasive mechanical ventilation, associated with a profound loss...

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Autores principales: Mirea, Liliana, Cobilinschi, Cristian, Ungureanu, Raluca, Cotae, Ana-Maria, Darie, Raluca, Tincu, Radu, Avram, Oana, Constantinescu, Sorin, Minoiu, Costin, Baetu, Alexandru, Grintescu, Ioana Marina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179085/
https://www.ncbi.nlm.nih.gov/pubmed/37176778
http://dx.doi.org/10.3390/jcm12093338
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author Mirea, Liliana
Cobilinschi, Cristian
Ungureanu, Raluca
Cotae, Ana-Maria
Darie, Raluca
Tincu, Radu
Avram, Oana
Constantinescu, Sorin
Minoiu, Costin
Baetu, Alexandru
Grintescu, Ioana Marina
author_facet Mirea, Liliana
Cobilinschi, Cristian
Ungureanu, Raluca
Cotae, Ana-Maria
Darie, Raluca
Tincu, Radu
Avram, Oana
Constantinescu, Sorin
Minoiu, Costin
Baetu, Alexandru
Grintescu, Ioana Marina
author_sort Mirea, Liliana
collection PubMed
description Considering the prioritization of life-threatening injuries in trauma care, secondary dysfunctions such as ventilator-induced diaphragmatic dysfunction (VIDD) are often overlooked. VIDD is an entity induced by muscle inactivity during invasive mechanical ventilation, associated with a profound loss of diaphragm muscle mass. In order to assess the incidence of VIDD in polytrauma patients, we performed an observational, retrospective, longitudinal study that included 24 polytraumatized patients. All included patients were mechanically ventilated for at least 48 h and underwent two chest CT scans during their ICU stay. Diaphragmatic thickness was measured by two independent radiologists on coronal and axial images at the level of celiac plexus. The thickness of the diaphragm was significantly decreased on both the left and right sides (left side: −0.82 mm axial p = 0.034; −0.79 mm coronal p = 0.05; right side: −0.94 mm axial p = 0.016; −0.91 coronal p = 0.013). In addition, we obtained a positive correlation between the number of days of mechanical ventilation and the difference between the two measurements of the diaphragm thickness on both sides (r =0.5; p = 0.02). There was no statistically significant correlation between the body mass indexes on admission, the use of vitamin C or N-acetyl cysteine, and the differences in diaphragmatic thickness.
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spelling pubmed-101790852023-05-13 A Trend towards Diaphragmatic Muscle Waste after Invasive Mechanical Ventilation in Multiple Trauma Patients—What to Expect? Mirea, Liliana Cobilinschi, Cristian Ungureanu, Raluca Cotae, Ana-Maria Darie, Raluca Tincu, Radu Avram, Oana Constantinescu, Sorin Minoiu, Costin Baetu, Alexandru Grintescu, Ioana Marina J Clin Med Brief Report Considering the prioritization of life-threatening injuries in trauma care, secondary dysfunctions such as ventilator-induced diaphragmatic dysfunction (VIDD) are often overlooked. VIDD is an entity induced by muscle inactivity during invasive mechanical ventilation, associated with a profound loss of diaphragm muscle mass. In order to assess the incidence of VIDD in polytrauma patients, we performed an observational, retrospective, longitudinal study that included 24 polytraumatized patients. All included patients were mechanically ventilated for at least 48 h and underwent two chest CT scans during their ICU stay. Diaphragmatic thickness was measured by two independent radiologists on coronal and axial images at the level of celiac plexus. The thickness of the diaphragm was significantly decreased on both the left and right sides (left side: −0.82 mm axial p = 0.034; −0.79 mm coronal p = 0.05; right side: −0.94 mm axial p = 0.016; −0.91 coronal p = 0.013). In addition, we obtained a positive correlation between the number of days of mechanical ventilation and the difference between the two measurements of the diaphragm thickness on both sides (r =0.5; p = 0.02). There was no statistically significant correlation between the body mass indexes on admission, the use of vitamin C or N-acetyl cysteine, and the differences in diaphragmatic thickness. MDPI 2023-05-08 /pmc/articles/PMC10179085/ /pubmed/37176778 http://dx.doi.org/10.3390/jcm12093338 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Mirea, Liliana
Cobilinschi, Cristian
Ungureanu, Raluca
Cotae, Ana-Maria
Darie, Raluca
Tincu, Radu
Avram, Oana
Constantinescu, Sorin
Minoiu, Costin
Baetu, Alexandru
Grintescu, Ioana Marina
A Trend towards Diaphragmatic Muscle Waste after Invasive Mechanical Ventilation in Multiple Trauma Patients—What to Expect?
title A Trend towards Diaphragmatic Muscle Waste after Invasive Mechanical Ventilation in Multiple Trauma Patients—What to Expect?
title_full A Trend towards Diaphragmatic Muscle Waste after Invasive Mechanical Ventilation in Multiple Trauma Patients—What to Expect?
title_fullStr A Trend towards Diaphragmatic Muscle Waste after Invasive Mechanical Ventilation in Multiple Trauma Patients—What to Expect?
title_full_unstemmed A Trend towards Diaphragmatic Muscle Waste after Invasive Mechanical Ventilation in Multiple Trauma Patients—What to Expect?
title_short A Trend towards Diaphragmatic Muscle Waste after Invasive Mechanical Ventilation in Multiple Trauma Patients—What to Expect?
title_sort trend towards diaphragmatic muscle waste after invasive mechanical ventilation in multiple trauma patients—what to expect?
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179085/
https://www.ncbi.nlm.nih.gov/pubmed/37176778
http://dx.doi.org/10.3390/jcm12093338
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