Related Experiment Video
Updated: May 3, 2026

Author Spotlight: Unraveling the Impact of Mechanical Ventilation on Diaphragm Function and Patient Outcomes
Published on: November 3, 2023
Difficult to wean: think of the diaphragm
Jandhyala Suryanarayana1, Muralidhar Varma, Sudha Vidyasagar
1Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
Abstract:
A 65-year-old woman, treated for non-ST segment elevation myocardial infarction and unexplained type 2 respiratory failure, was referred to our hospital in view of difficulty in weaning off the ventilator. She was evaluated in detail for persistent hypercapnia. Ultrasound of the diaphragm showed minimal excursion of diaphragm while she was off the ventilator and fluoroscopy confirmed bilateral diaphragmatic palsy. As extensive radiological, immunological and microbiological workup ruled out other possible aetiologies, a diagnosis of idiopathic Bell's palsy of the diaphragm was made. She was treated with valacyclovir and steroids after which she gradually recovered and was weaned off the ventilator.
Related Concept Videos
Pulmonary Cycle: Exhalation
Muscles of the Thorax
The diaphragm is at the core of thoracic musculature, the primary muscle involved in breathing. This expansive, dome-shaped muscle marks the division between the thoracic and abdominal cavities. It...
Endotracheal Tube Extubation
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Pulmonary Ventilation: Inhalation
Boyle's law becomes particularly pertinent when examining respiratory...
Breathing
Mechanism of Breathing III: The Accessory Muscles
The respiratory system is a complex network that relies on primary respiratory muscles like the diaphragm, but also involves accessory muscles to enhance lung expansion and airflow during both inhalation and exhalation.
Enhancing Inhalation with Accessory Muscles:
Accessory muscles such as the sternocleidomastoid, scalene, intercostal, and abdominal muscles are crucial when additional respiratory effort is required, such as during deep...

