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Expiratory muscle dysfunction in critically ill patients: towards improved understanding
INTRODUCTION: This narrative review summarizes current knowledge on the physiology and pathophysiology of expiratory muscle function in ICU patients, as shared by academic professionals from multidisciplinary, multinational backgrounds, who include clinicians, clinical physiologists and basic physio...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667683/ https://www.ncbi.nlm.nih.gov/pubmed/31236639 http://dx.doi.org/10.1007/s00134-019-05664-4 |
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author | Shi, Zhong-Hua Jonkman, Annemijn de Vries, Heder Jansen, Diana Ottenheijm, Coen Girbes, Armand Spoelstra-de Man, Angelique Zhou, Jian-Xin Brochard, Laurent Heunks, Leo |
author_facet | Shi, Zhong-Hua Jonkman, Annemijn de Vries, Heder Jansen, Diana Ottenheijm, Coen Girbes, Armand Spoelstra-de Man, Angelique Zhou, Jian-Xin Brochard, Laurent Heunks, Leo |
author_sort | Shi, Zhong-Hua |
collection | PubMed |
description | INTRODUCTION: This narrative review summarizes current knowledge on the physiology and pathophysiology of expiratory muscle function in ICU patients, as shared by academic professionals from multidisciplinary, multinational backgrounds, who include clinicians, clinical physiologists and basic physiologists. RESULTS: The expiratory muscles, which include the abdominal wall muscles and some of the rib cage muscles, are an important component of the respiratory muscle pump and are recruited in the presence of high respiratory load or low inspiratory muscle capacity. Recruitment of the expiratory muscles may have beneficial effects, including reduction in end-expiratory lung volume, reduction in transpulmonary pressure and increased inspiratory muscle capacity. However, severe weakness of the expiratory muscles may develop in ICU patients and is associated with worse outcomes, including difficult ventilator weaning and impaired airway clearance. Several techniques are available to assess expiratory muscle function in the critically ill patient, including gastric pressure and ultrasound. CONCLUSION: The expiratory muscles are the "neglected component" of the respiratory muscle pump. Expiratory muscles are frequently recruited in critically ill ventilated patients, but a fundamental understanding of expiratory muscle function is still lacking in these patients. |
format | Online Article Text |
id | pubmed-6667683 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-66676832019-08-14 Expiratory muscle dysfunction in critically ill patients: towards improved understanding Shi, Zhong-Hua Jonkman, Annemijn de Vries, Heder Jansen, Diana Ottenheijm, Coen Girbes, Armand Spoelstra-de Man, Angelique Zhou, Jian-Xin Brochard, Laurent Heunks, Leo Intensive Care Med Review INTRODUCTION: This narrative review summarizes current knowledge on the physiology and pathophysiology of expiratory muscle function in ICU patients, as shared by academic professionals from multidisciplinary, multinational backgrounds, who include clinicians, clinical physiologists and basic physiologists. RESULTS: The expiratory muscles, which include the abdominal wall muscles and some of the rib cage muscles, are an important component of the respiratory muscle pump and are recruited in the presence of high respiratory load or low inspiratory muscle capacity. Recruitment of the expiratory muscles may have beneficial effects, including reduction in end-expiratory lung volume, reduction in transpulmonary pressure and increased inspiratory muscle capacity. However, severe weakness of the expiratory muscles may develop in ICU patients and is associated with worse outcomes, including difficult ventilator weaning and impaired airway clearance. Several techniques are available to assess expiratory muscle function in the critically ill patient, including gastric pressure and ultrasound. CONCLUSION: The expiratory muscles are the "neglected component" of the respiratory muscle pump. Expiratory muscles are frequently recruited in critically ill ventilated patients, but a fundamental understanding of expiratory muscle function is still lacking in these patients. Springer Berlin Heidelberg 2019-06-24 2019 /pmc/articles/PMC6667683/ /pubmed/31236639 http://dx.doi.org/10.1007/s00134-019-05664-4 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Review Shi, Zhong-Hua Jonkman, Annemijn de Vries, Heder Jansen, Diana Ottenheijm, Coen Girbes, Armand Spoelstra-de Man, Angelique Zhou, Jian-Xin Brochard, Laurent Heunks, Leo Expiratory muscle dysfunction in critically ill patients: towards improved understanding |
title | Expiratory muscle dysfunction in critically ill patients: towards improved understanding |
title_full | Expiratory muscle dysfunction in critically ill patients: towards improved understanding |
title_fullStr | Expiratory muscle dysfunction in critically ill patients: towards improved understanding |
title_full_unstemmed | Expiratory muscle dysfunction in critically ill patients: towards improved understanding |
title_short | Expiratory muscle dysfunction in critically ill patients: towards improved understanding |
title_sort | expiratory muscle dysfunction in critically ill patients: towards improved understanding |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667683/ https://www.ncbi.nlm.nih.gov/pubmed/31236639 http://dx.doi.org/10.1007/s00134-019-05664-4 |
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