Pressure support ventilation attenuates ventilator-induced protein modifications in the diaphragm 英文参考文献.docVIP

Available online /content/12/6/191 Commentary Pressure support ventilation attenuates ventilator-induced protein modifications in the diaphragm Scott K Powers1 , Marc DeCramer2, Ghislaine Gayan-Ramirez2 and Sanford Levine3 1Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32608, USA 2Respiratory Rehabilitation and Respiratory Division, University Hospitals, Catholic University of Leuven, B-3000 Leuven, Belgium 3Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA Corresponding author: Scott K Powers, spowers@ Published: 7 November 2008 Critical Care 2008, 12:191 (doi:10.1186/cc7095) This article is online at /content/12/6/191 ? 2008 BioMed Central Ltd See related research by Futier et al., /content/12/5/R116 Abstract prevented by using a pressure support mode of mechanical ventilation. Specifically, this study suggests that pressure support ventilation is efficient in maintaining diaphragmatic protein synthesis and retarding CMV-induced diaphragmatic proteolysis. Although this work provides several interesting observations, these experiments did not include direct measurements of diaphragmatic fiber cross-sectional area or the assessment of diaphragmatic contractile function. These additional measures would have greatly improved our under- standing of the clinical benefit provided by this mode of mechanical ventilation. For example, in similar experiments, Sassoon and colleagues [8] reported that assist-control mechanical ventilation attenuated the diaphragmatic contrac- tile dysfunction induced by complete diaphragmatic inactivity during CMV. Nonetheless, three days of assist-control mech- anical ventilation resulted in a 20% reduction in diaphrag- matic peak power output without significant changes in both diaphragmatic contractile proteins and the expression of