Combined Diaphragm and Limb Muscle Atrophy Is Associated With Increased Mortality in Mechanically Ventilated Patients: A Pilot Study

Carámbula, Agustín; Pereyra, Sebastián; Barbato, Marcelo; Angulo, Martín

doi:10.1016/j.arbres.2020.12.031

Cited by 4 publications

(3 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In fact, each described atrophy occurring at the hindlimb fast-twitch muscle tibialis anterior (TA), as well as a decrease in hindlimb contractile force determined in vivo. The pattern of muscle compromise described both in patients with ARDS and in different animal models is highly heterogeneous (Carambula et al, 2021;Divangahi et al, 2004;Shiota et al, 2004). Therefore, we aimed to further investigate the morphologic and functional properties of three different muscles during the course of murine acute lung injury and resolution stages.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Peripheral and respiratory muscle impairment during murine acute lung injury

Angulo

Vacca

Rodríguez

et al. 2022

Physiological Reports

Self Cite

View full text Add to dashboard Cite

Acute respiratory distress syndrome is associated with skeletal muscle compromise, which decreases survival and impairs functional capacity. A comparative analysis of peripheral and respiratory muscles' atrophy and dysfunction in acute lung injury (ALI) has not been performed. We aimed to evaluate diaphragmatic and peripheral muscle mass and contractility in an ALI animal model. ALI was induced in C57BL/6 mice by intratracheal lipopolysaccharides instillation.Muscle mass and in vitro contractility were evaluated at different time points in hindlimb soleus (slow-twitch) and extensor digitorum longus (EDL, fast-twitch), as well as in the main respiratory muscle diaphragm. Myogenic precursor satellite cell-specific transcription factor Pax7 expression was determined by Western blot. Lung injury was associated with atrophy of the three studied muscles, although it was more pronounced and persistent in the diaphragm. Specific contractility was reduced during lung injury in EDL muscle but restored by the time lung injury has resolved. Specific force was not affected in soleus and diaphragm.A persistent increase in Pax7 expression was detected in diaphragm and EDL muscles after induction of ALI, but not in soleus muscle. Different peripheral and respiratory skeletal muscles are distinctly affected during the course of ALI. Each of the studied muscles presented a unique pattern in terms of atrophy development, contractile dysfunction and Pax7 expression.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Different profiles of peripheral and respiratory muscle atrophy and weakness have been described in critically ill patients (Carambula et al, 2021; Dres et al, 2017; Puthucheary et al, 2013). Moreover, diverse muscle groups are affected to different degrees (Campbell et al, 1995; Jung et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Peripheral and respiratory muscle impairment during murine acute lung injury

Angulo

Vacca

Rodríguez

et al. 2022

Physiological Reports

Self Cite

View full text Add to dashboard Cite

show abstract

“…In the ICU setting, diaphragm dysfunction, assessed by ultrasound, is very frequently associated with reduced lower limb strength and muscle size, also assessed by ultrasound, two proxies of acute sarcopenia. Overall, these studies indicate that the association between diaphragm dysfunction and lower limb muscle wasting is predictive of adverse outcomes [ 130 , 184 , 185 , 186 , 187 , 188 ]. However, these studies were mainly focused on children or adult patients.…”

Section: Diaphragm Ultrasound In Geriatric Patients With Frailty and ...mentioning

confidence: 99%

Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients

Siniscalchi,

Nouvenne,

Cerundolo

et al. 2024

Geriatrics

View full text Add to dashboard Cite

Diaphragm muscle dysfunction is increasingly recognized as a fundamental marker of several age-related diseases and conditions including chronic obstructive pulmonary disease, heart failure and critical illness with respiratory failure. In older individuals with physical frailty and sarcopenia, the loss of muscle mass and function may also involve the diaphragm, contributing to respiratory dysfunction. Ultrasound has recently emerged as a feasible and reliable strategy to visualize diaphragm structure and function. In particular, it can help to predict the timing of extubation in patients undergoing mechanical ventilation in intensive care units (ICUs). Ultrasonographic evaluation of diaphragmatic function is relatively cheap, safe and quick and can provide useful information for real-time monitoring of respiratory function. In this review, we aim to present the current state of scientific evidence on the usefulness of ultrasound in the assessment of diaphragm dysfunction in different clinical settings, with a particular focus on older patients. We highlight the importance of the qualitative information gathered by ultrasound to assess the integrity, excursion, thickness and thickening of the diaphragm. The implementation of bedside diaphragm ultrasound could be useful for improving the quality and appropriateness of care, especially in older subjects with sarcopenia who experience acute respiratory failure, not only in the ICU setting.

show abstract