Related Experiment Video
Updated: Aug 15, 2026
05:51
Measuring Diaphragm Thickness and Function Using Point-of-Care Ultrasound
Published on: November 3, 2023
Risk factors for diaphragmatic dysfunction in mechanically ventilated patients: a systematic review and meta-analysis
Ruixin Che1, Shiqin Pan2, Jinhai Han2
1Qinghai University, Xining, China.
Frontiers in Medicine
|August 14, 2026
Summary
Infection, disease severity, older age, and higher BMI increase the risk of diaphragmatic dysfunction (DD) in mechanically ventilated patients. Maintaining good nutrition and muscle strength can protect against DD.
Area of Science:
- Critical Care Medicine
- Respiratory Medicine
- Clinical Research
Background:
- Diaphragmatic dysfunction (DD) is a significant complication in mechanically ventilated (MV) patients.
- Identifying risk factors for DD is crucial for improving patient outcomes and reducing ventilator dependence.
Purpose of the Study:
- To systematically identify and evaluate risk factors associated with diaphragmatic dysfunction (DD) in mechanically ventilated patients.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (PubMed, Embase, Web of Science, etc.) up to July 2025.
- Included studies were case-control, cohort, and cross-sectional designs focusing on risk factors for DD in MV patients.
- Meta-analyses were performed using Review Manager 5.4 to pool data from eleven included studies involving 5,272 patients.
Main Results:
- Infection/sepsis (OR=2.65), higher APACHE II score (OR=1.19), older age (OR=1.02), and higher BMI (OR=1.03) were independently associated with increased DD risk.
- Higher serum albumin (OR=0.88) and greater grip strength (OR=0.70) were identified as protective factors against DD.
- Due to incompatible operationalizations and heterogeneity, MV-related exposures and surgery-related factors could not be conclusively pooled.
Conclusions:
- Sepsis/infection, disease severity, advanced age, and elevated BMI are key risk factors for DD in MV patients.
- Adequate nutritional status and preserved muscle strength serve as protective elements against DD.
- Early identification of at-risk individuals, alongside nutritional optimization and infection control, may decrease DD incidence.
Related Concept Videos
01:10Atelectasis II: Pathophysiology
Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through collapsed...
01:30Acute Respiratory Failure-III
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
01:29Mechanical Ventilation I: Indication and Settings
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
01:19Factors Affecting Pulmonary Ventilation
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:23Acute Respiratory Failure-IV
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
01:30Respiratory System Abnormal Finding I: Inspection and Percussion
Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...