Novel insights in the function of the respiratory pump in ventilated ICU patients

In the last decade, it has become clear that mechanical ventilation itself is an important contributing factor in the development of respiratory muscle dysfunction, which is associated with adverse outcomes, prolonged ICU admission and increased mortality. Ventilator-induced respiratory muscle dysfunction is caused by excessive unloading or unnoticed loading of the respiratory muscles. To date, most studies focused mainly on the effect of different ventilatory modes and levels of assist at the main inspiratory muscle, the diaphragm. In this thesis, we examined the effect of other frequently used ventilatory settings and the impact of the expiratory
muscles on the pathophysiology of diaphragm dysfunction. In addition, several monitoring tools and preventive strategies were investigated.