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首页> 外文期刊>Critical care : >Bench-to-bedside review: Diaphragm muscle function in disuse and acute high-dose corticosteroid treatment
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Bench-to-bedside review: Diaphragm muscle function in disuse and acute high-dose corticosteroid treatment

机译：从床到床的回顾：废弃时的Dia肌功能和急性大剂量皮质类固醇治疗

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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 diaphragm, and to administer the lowest dose of corticosteroid for the shortest duration possible.
机译：重症患者可能需要机械通气支持和短期大剂量糖皮质激素治疗某些特定的潜在疾病过程。由受控的机械通气引起的muscle肌不活动会导致diaphragm肌结构发生巨大变化，并严重丧失功能。尽管造成diaphragm肌功能丧失的确切机制仍是未知的，但最近的研究强调了蛋白水解和氧化应激的重要性。在实验动物中，维持部分diaphragm肌神经机械激活的短期策略可减轻diaphragm肌力损失。在动物模型中，对机械控制通气和短期大剂量甲基强的松龙联合使用的影响的研究在对diaphragm肌功能的影响方面未取得一致的结果。在重症患者中，需要进一步的研究来确定呼吸机引起的diaphragm肌功能障碍的发生率和机制，以及机械通气和大剂量皮质类固醇给药之间的可能相互作用。在此之前，为照顾这些患者，必须使allow肌部分激活，并在尽可能短的时间内给予最低剂量的皮质类固醇激素。

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