2024 Volume 44 Issue 3 Pages 344-350
Lung protective ventilation is crucial to minimize lung injury in patients with acute respiratory distress syndrome. Once lung protective ventilation is achieved, efforts should be made to protect the diaphragm. Diminished respiratory work by excessive respiratory support leads to disuse atrophy of the diaphragm. Conversely, excessive respiratory work can lead to load-induced diaphragm injury. In addition, inadequate PEEP and asynchrony, such as reverse triggering and premature cycling, can cause muscle injury due to eccentric contraction of the diaphragm. Preventing diaphragm dysfunction by maintaining appropriate respiratory work, setting appropriate PEEP, and improving asynchrony may facilitate ventilator weaning.
