tailieunhanh - Báo cáo y học: " Bench-to-bedside review: Diaphragm muscle function in disuse and acute high-dose corticosteroid treatment"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Bench-to-bedside review: Diaphragm muscle function in disuse and acute high-dose corticosteroid treatment. | Available online http content 13 5 221 Review Bench-to-bedside review Diaphragm muscle function in disuse and acute high-dose corticosteroid treatment Catherine SH Sassoon1 2 and Vincent J Caiozzo3 1 Department of Medicine University of California Irvine California USA 2Department of Medicine Pulmonary and Critical Care Section VA Long Beach Healthcare System 11 111P 5901 East 7th Street Long Beach CA 90822 USA 3Department of Orthopedic Surgery Physiology and Biophysics University of California Irvine California USA Corresponding author Catherine SH Sassoon csassoon@ Published 8 September 2009 This article is online at http content 13 5 221 2009 BioMed Central Ltd Critical Care 2009 13 221 doi cc7971 Abstract Critically ill patients may require mechanical ventilatory support and short-term high-dose corticosteroid to treat some specific underlying disease processes. Diaphragm muscle inactivity induced by controlled mechanical ventilation produces dramatic alterations in diaphragm muscle structure and significant losses in function. Although the exact mechanisms responsible for losses in diaphragm muscle function are still unknown recent studies have highlighted the importance of proteolysis and oxidative stress. In experimental animals short-term strategies that maintain partial diaphragm muscle neuromechanical activation mitigate diaphragmatic force loss. In animal models studies on the influence of combined controlled mechanical ventilation and short-term high-dose methylprednisolone have given inconsistent results in regard to the effects on diaphragm muscle function. In the critically ill patient further research is needed to establish the prevalence and mechanisms of ventilator-induced diaphragm muscle dysfunction and the possible interaction between mechanical ventilation and the administration of high-dose corticosteroid. Until then in caring for these patients it is imperative to allow partial activation of the .