Diaphragmatic dysfunction in critically patients undergoing mechanical ventilation

Mechanical ventilation (MV) is an important cause of diaphragmatic weakness, associated with a syndrome known as ventilator Induced Diaphragmatic Disfunction (VIDD). The latter is determined by a heavy unload or overload of the diaphragm due to patient-ventilator asynchrony. It is important to minimize the duration of MV to optimize respiratory muscle function and to develop successful strategies that reduce the length of stay of ICU and days of MV. The primary endpoint of this project is to evaluate the ability of ultrasound in evaluating diaphragmatic contractility in relation to a possible diaphragm injury, as well as serum markers of muscle injury, during assisted MV. We will evaluate the relationship between diaphragmatic thickness and displacement with ventilator parameters (e.g. Eadi, Eadi max), titrate Neurally Adjusted Ventilator Assist (NAVA) level or PSV level assistance in order to improve ventilator trigger delay and synchrony, assessed by diaphragmatic ultrasonography.