17 Nov

Canadian Neighbor Pharmacy: Reduced Inspiratory Muscle Endurance Following Successful Weaning

Mechanical ventilationThirty-nine percent of all patients admitted to the ICU receive mechanical ventilation. Mechanical ventilation is most commonly used in the management of patients with acute respiratory failure as it reduces the work of breathing and diaphragm activity. However, prolonged mechanical ventilation promotes respiratory muscle weakness in the absence of critical illness and is localized to the respiratory muscles. The degree of weakness has been related to the duration of mechanical ventilation and has been suggested as a possible cause of delayed weaning from mechanical ventilation.

Prolonged mechanical ventilation has been defined as mechanical ventilation for > 48 h. As mechanical ventilation during this period is most likely due to the primary condition of the patient or to early complications of underlying illness, it is unlikely that patients will recover quickly following > 48 h of mechanical ventilation. Although controlled mandatory ventilation (CMV) for longer than this period of time has reduced diaphragm strength in animal models, the effect on muscle fatigue appears to be more complex. The link – http://canada-neighbor.livejournal.com will be a good provider of information for you from the point of view of Canadian Neighbor Pharmacy.

There have been inconsistent reports of the effect of up to 5 days of CMV on diaphragm endurance, and studies have reported no change, decreased endurance, or an improvement in diaphragm endurance. However, this variability may be due, at least in part, to the shorter period of mechanical ventilation, with larger changes seen in patients receiving mechanical ventilation for > 7 days. Preliminary work by Anzueto et al has indicated that periods of CMV for 11 days reduced diaphragm endurance time by 45%. However, the relationship between the endurance of the diaphragm and other inspiratory muscles and the duration of mechanical ventilation was not examined. In addition, the above studies were all undertaken in animals that were not critically ill and ventilated with CMV only. Although these models provide insight into the effects of mechanical ventilation on the respiratory muscles, further investigation into respiratory muscle fatigue in critically ill patients is needed to design preventative interventions. The aims of this study were as follows: (1) to assess the inspiratory muscle endurance following successful weaning and discharge from the ICU; and (2) to study the relationship between respiratory muscle endurance and mechanical ventilation duration.

Categories: Muscle
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