ty -jour t1-呼吸机诱导的diaphragm功能障碍：（cont）动作的时间！JF-欧洲呼吸杂志JO -EUR RESSIR J SP -12 lp -15 do -10.1183/09031936.00076513 VL -42 IS -1 AU -GAYAN -RAMIREZ，GHISLAINE Y1 -2013/07/07/01 UR -HTTP：// HTTP：//ERJ.ERSJOURJ.ERSJOURNALS.com/content/42/1/12.Abstract N2-在过去的10年中，密集的实验研究集中在机械通气对膜片的影响上。无论研究什么动物，所有这些研究都一贯表明机械通气受损的隔膜功能，从而导致所谓的呼吸机诱导的隔膜功能障碍（VIDD）[1-9]。这种效果的发展很快，随着呼吸机上花费的时间[5]。它与早期的隔膜纤维萎缩有关，最终与隔膜减肥和隔膜超微结构改变有关，肌肉瘤的结构混乱[8]。在机械通气后，氧化应激，蛋白质合成降低和蛋白水解的增加均已报道[8]。这些数据表明，机械通气后使健康的膜片患病。长期以来，这些数据的重要性被忽略了，这可能是由于研究的实验性质。但是Levine等人的研究。[10]在通风的脑死亡器官供体中，揭示了快速的隔膜纤维萎缩和增强的蛋白水解，就像动物模型一样，强调了机械通气效应并非实验室模型独有的事实。 Subsequent studies in animal models, and also in humans, have further documented the impact of controlled mechanical ventilation on the diaphragm [11–20]. Despite this evidence, the impact of VIDD as an important component of diaphragm disability during mechanical ventilation remains questioned. It has been claimed that the available data pertain to controlled mechanical ventilation, a ventilation mode which is not the preferential mode of ventilation in patients. Well, this is true, although this ventilation mode is a necessary tool in particular situations (e.g. in patients treated with neuromuscular blocking agents, in attempts to minimise oxygen consumption, and in patients with central … ER -