Maintenance of spontaneous breathing at an intensity of 60%-80% may effectively prevent mechanical ventilation-induced diaphragmatic dysfunction

Controlled mechanical ventilation (CMV) can cause diaphragmatic motionlessness to induce diaphragmatic dysfunction. Partial maintenance of spontaneous breathing (SB) can reduce ventilation-induced diaphragmatic dysfunction (VIDD). However, to what extent SB is maintained in CMV can attenuate or even...

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Bibliographic Details
Published in:PloS one 2020-03, Vol.15 (3), p.e0229944-e0229944
Main Authors: Luo, Zujin, Han, Silu, Sun, Wei, Wang, Yan, Liu, Sijie, Yang, Liu, Pang, Baosen, Jin, Jiawei, Chen, Hong, Cao, Zhixin, Ma, Yingmin
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Calpain
Caspase-3
Critical care
Engineering research
Enzyme-linked immunosorbent assay
Intensive care
Laboratory animals
Maintenance
Mechanical ventilation
Medicine
Medicine and Health Sciences
Muscles
Nerves
Oxidative stress
Pressure
Research and Analysis Methods
Sensors
Ventilation
Ventilators
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Summary:Controlled mechanical ventilation (CMV) can cause diaphragmatic motionlessness to induce diaphragmatic dysfunction. Partial maintenance of spontaneous breathing (SB) can reduce ventilation-induced diaphragmatic dysfunction (VIDD). However, to what extent SB is maintained in CMV can attenuate or even prevent VIDD has been rarely reported. The current study aimed to investigate the relationship between SB intensity and VIDD and to identify what intensity of SB maintained in CMV can effectively avoid VIDD. Adult rats were randomly divided according to different SB intensities: SB (0% pressure controlled ventilation (PCV)), high-intensity SB (20% PCV), medium-intensity SB (40% PCV), medium-low intensity SB (60% PCV), low-intensity SB (80% PCV), and PCV (100% PCV). The animals underwent 24-h controlled mechanical ventilation (CMV). The transdiaphragmatic pressure (Pdi), the maximal Pdi (Pdi max) when phrenic nerves were stimulated, Pdi/Pdi max, and the diaphragmatic tonus under different frequencies of electric stimulations were determined. Calpain and caspase-3 were detected using ELISA and the cross-section areas (CSAs) of different types of muscle fibers were measured. The Pdi showed a significant decrease from 20% PCV and the Pdi max showed a significant decrease from 40% PCV (P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0229944