Inspiratory muscle activity in neurally adjusted ventilatory assist: More than sonata for 'solo diaphragm'

摘要

MECHANICAL ventilation (MV) is the form of supportive therapy most frequently used in the intensive care unit. Although a life-saving intervention for patients admitted to intensive care unit with acute respiratory failure, MV is not free of side effects. Well-known complications of MV are ventilator-induced lung injury, high oxygen concentration toxicity, upper airway damage or dysfunction, inappropriate and delayed sedation, acquired pulmonary infections, altered hemo-dynamics, sleep disturbances, and psychic distress. Two additional issues have been increasingly recognized in the last decade as major problems associated with MV, ventilator-induced diaphragmatic dysfunction and a poor patient-ventilator interaction leading to dyssynchrony between spontaneous respiration and ventilator assistance.