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Impact of under-assisted ventilation on diaphragm function and structure in a porcine model

Title: Impact of under-assisted ventilation on diaphragm function and structure in a porcine model
Authors: Capdevila, Mathieu; Pensier, Joris; de Jong, Audrey; Jung, Boris; Beghin, July; Laumon, Thomas; Aarab, Yassir; Deffontis, Lucas; Sfara, Thomas; Cuny, Ambre; Carr, Julie; Molinari, Nicolas; Le Guennec, Jean-Yves; Raynaud, Fabrice; Matecki, Stefan; Brochard, Laurent; Lacampagne, Alain; Jaber, Samir
Contributors: Hôpital Saint Eloi CHU Montpellier; Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp); Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM); Hôpital Lapeyronie CHU Montpellier; Médecine de précision par intégration de données et inférence causale (PREMEDICAL); Centre Inria d'Université Côte d'Azur; Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM); Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM); Interdepartmental Division of Critical Care Medicine; University of Toronto; Keenan Research Centre of the Li Ka Shing Knowledge Institute Toronto; Support was provided solely from institutional and/or departmental sources.
Source: ISSN: 0003-3022 ; Anesthesiology ; https://hal.science/hal-04911765 ; Anesthesiology, 2025, ⟨10.1097/ALN.0000000000005390⟩.
Publisher Information: CCSD; Lippincott, Williams & Wilkins
Publication Year: 2025
Collection: Université de Montpellier: HAL
Subject Terms: [SDV]Life Sciences [q-bio]
Description: International audience ; Background: Long-term controlled mechanical ventilation (CMV) in intensive care unit (ICU) induces ventilatory-induced-diaphragm-dysfunction (VIDD). The transition from CMV to assisted mechanical ventilation is a challenge that requires clinicians to balance over-assistance and under-assistance. While the effects of over-assistance on the diaphragm are well known, we aimed to assess the impact of under-assistance on diaphragm function and structure in piglet model with pre-existing VIDD (after long-term CMV) or without VIDD (short-term CMV). Methods: Twenty-two Large-White female piglets were anesthetized, ventilated, and separated into two groups: a VIDD group (n=10) with long-term 72-hour CMV, and a no-VIDD group (n=12) with short-term 2-hour CMV. After sedation reduction at the end of CMV period, each piglet was switched to under-assisted ventilation for 2 hours. Diaphragm function (supramaximal diaphragm pressure-generating capacity assessed by negative tracheal pressure after transvenous phrenic nerve stimulation) and diaphragm structure (mini-invasive in vivo biopsies) were assessed before and after under-assisted ventilation. Results: In VIDD group, supramaximal diaphragm pressure-generating capacity decreased by 22% from 69.9±12.7 to 54.9±19.7 cmH2O ( p =0.04) after 72 hours of CMV evidencing VIDD, then dropped by a further 29% from 54.9±19.7 to 38.9±15.5 cmH2O ( p
Document Type: article in journal/newspaper
Language: English
DOI: 10.1097/ALN.0000000000005390
Availability: https://hal.science/hal-04911765; https://hal.science/hal-04911765v1/document; https://hal.science/hal-04911765v1/file/2025%20Capdevila%20et%20al.,%20Impact%20of%20under.pdf; https://doi.org/10.1097/ALN.0000000000005390
Rights: https://hal.science/licences/copyright/ ; info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.5B228FA6
Database: BASE