A patient who receives ventilator support may develop diaphragmatic dysfunction, referred to as ventilator-induced diaphragm dysfunction (VIDD). It may arise from irreversible damage to mitochondria.
VIDD is associated with atrophy of diaphragm muscles with dysfunction. It can start within 12 hours of starting mechanical ventilator support.
Imaging studies such as ultrasonography will show thinning of the diaphragm and decreased excursion during deep inspiration.
Risk factors:
(1) critical illness myopathy
(2) protein malnutrition
(3) prolonged mechanical ventilation
(4) risk factors for acquired diaphragmatic dysfunction
(5) adverse drug effects (corticosteroids, etc)
Significance:
(1) difficulty weaning
(2) prolonged disability
Differential diagnosis:
(1) progression of disorder necessitating ventilator support
(2) other factors interfering with respiratory muscles other than the diaphragm
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