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Assist-control mechanical ventilation attenuates ventilator-induced diaphragmatic dysfunction.

Catherine S H Sassoon1, Ercheng Zhu, Vincent J Caiozzo

  • 1Departmen of Medicine, VA Long Beach Healthcare System, Long Beach, California 90822, USA. csassoon@uci.edu

American Journal of Respiratory and Critical Care Medicine
|June 18, 2004
PubMed
Summary

Assisted mechanical ventilation preserves diaphragm force and prevents muscle atrophy by maintaining MAF-box gene expression. Controlled ventilation leads to significant diaphragm dysfunction and atrophy.

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Area of Science:

  • Physiology
  • Muscle Biology

Background:

  • Mechanical ventilation can cause diaphragm muscle dysfunction and atrophy.
  • The impact of assisted mechanical ventilation on diaphragm contractile properties and muscle atrophy gene expression is not well understood.

Purpose of the Study:

  • To investigate the effects of assisted mechanical ventilation on diaphragm contractile function and MAF-box gene expression.
  • To compare these effects with controlled mechanical ventilation.

Main Methods:

  • Sedated rabbits were divided into control, assisted ventilation, and controlled ventilation groups.
  • In vitro diaphragmatic isometric and isotonic contractile function were assessed.
  • Contractile protein concentrations, myosin heavy chain isoform, and MAF-box mRNA were measured.

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Main Results:

  • Assisted ventilation resulted in a 14% decrease in tetanic force, while controlled ventilation caused a 48% decrease.
  • Peak power output decreased by 20% with assisted ventilation and 41% with controlled ventilation.
  • Controlled ventilation led to MAF-box gene overexpression, unlike assisted ventilation.

Conclusions:

  • Preserving diaphragmatic contractions during mechanical ventilation attenuates force loss and maintains MAF-box gene expression.
  • Assisted mechanical ventilation mitigates diaphragm dysfunction compared to controlled ventilation.