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Prolonged Mechanical Ventilation: Outcomes and Management

Hung-Yu Huang1,2,3, Chih-Yu Huang2,4, Li-Fu Li2,4

  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.

Journal of Clinical Medicine
|May 14, 2022
PubMed

Insights

Prolonged mechanical ventilation (PMV) is rising globally. Research into its causes, risks, and treatments, like addressing ventilator-induced diaphragm dysfunction, is vital for better patient outcomes and reduced healthcare costs.

Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Respiratory Physiology

Background:

  • Increasing global prevalence of patients requiring prolonged mechanical ventilation (PMV).
  • Significant burden on healthcare systems due to rising PMV cases.
  • Need for comprehensive understanding of PMV pathophysiology, risk factors, and treatment.

Purpose of the Study:

  • To investigate the pathophysiology of PMV, focusing on abnormal respiratory drive and ventilator-induced diaphragm dysfunction (VIDD).
  • To review existing evidence on risk factors and treatments for PMV.
  • To highlight the need for rigorous, controlled studies to advance PMV management.

Main Methods:

  • Review of existing clinical and animal experimental studies on PMV pathophysiology.
  • Analysis of studies investigating pharmacological agents and rehabilitative programs for PMV.
  • Identification of methodological limitations in current research.

Main Results:

  • Ventilator-induced diaphragm dysfunction (VIDD) is linked to increased mortality, nosocomial pneumonia, oxidative stress, hypoxia, and costs.
  • Pharmacological agents and rehabilitation show potential benefits but require further validation.
  • Current evidence is limited by methodological constraints.

Conclusions:

  • Further controlled prospective studies with adequate sample sizes are essential.
  • Evidence is needed on the precise mechanisms, prognosis, and optimal treatment strategies for PMV.
  • PMV represents a critical research area due to its epidemiological impact and treatment potential.
Keywords:
prolonged mechanical ventilationreactive oxygen speciesrespiratory driveventilator-induced diaphragm dysfunction

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