Respiratory muscle dysfunction of critical patients receiving mechanical ventilation due to acute respiratory failure: a literature review

Abstract

Impairment of breathing muscles is one of many consequences of mechanical ventilation in critical patients. In some cases, muscle weakness is due to patients’ disease itself. According to experimental studies conducted with animals, diaphragm force decreases after 12 hours of controlled mechanical ventilation. However, many factors might be responsible for such breathing muscles dysfunction and consequent difficulty in weaning from mechanical ventilation. The aim of the present review was to search for the causes of breathing muscle alterations in patients who present acute respiratory failure. The search in main electronic databases led to selecting experimental and review studies published in the last 10 years, most of which were conducted with animal models. According to the reviewed studies, impairment of breathing muscles is multi-factorial and might be related to sepsis, medicine consumption, nutrition deprivation, and to the controlled mechanical ventilation itself. It is mandatory to identify each of these factors since, either isolated or associated, they increase respiratory muscle dysfunction.