Diaphragm Dysfunction After Cardiac Surgery: Reappraisal

Laghlam, Driss; Lê, Minh Pierre; Srour, Alexandre; Monsonego, Raphael; Estagnasié, Philippe; Brusset, Alain; Squara, Pierre

doi:10.1053/j.jvca.2021.02.023

Cited by 19 publications

(27 citation statements)

References 31 publications

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“…Diaphragm dysfunction is common in ICU and affects prognosis, respiratory outcomes, length of hospital stay, and weaning process [4]. In ICU, the prevalence of diaphragm dysfunction at admission was reported to be up to 64% by Demoule et al [35], while in patients on weaning trials, the prevalence reached 23% to 80% [22,24,36].…”

Section: Diaphragm Dysfunction In Icumentioning

confidence: 99%

“…Diaphragm dysfunction is frequent after cardiac surgery, particularly after coronary artery bypass graft (CABG) [1] and in patients with diabetes mellitus [47]. In addition, obesity and arterial hypertension may be risk factors for post-operative diaphragmatic dysfunction [4]. Preoperative inspiratory muscle weakness may predict the postoperative duration of mechanical ventilation in patients undergoing cardiac surgery [5].…”

Section: Diaphragm Dysfunction In Cardiac Surgerymentioning

confidence: 99%

“…In the study by Diehl et al [3], that included 13 patients with DD, after cardiac surgery, the authors reported high morbidity and mortality, with the occurrence of nosocomial pneumonia, cardiorespiratory arrest after early extubation, prolonged mechanical ventilation, and death. In a recent French study that included 3577 patients, the presence of DD after cardiac surgery was associated with the risk of post-operative pneumonia, non-invasive ventilation, and invasive ventilation and an increase of ICU hospital length of stay [4]. Table 3 summarizes studies that assessed diaphragm function and clinical outcomes of adult patients after cardiac surgery.…”

Section: Diaphragm Dysfunction In Cardiac Surgerymentioning

confidence: 99%

“…In cardiac surgery, patients are at risk of phrenic nerve injury, which leads to diaphragm dysfunction (DD) [1]. The onset of DD is a serious outcome, affecting morbidity and length of hospital stay [1][2][3][4][5]. This is particularly a pejorative burden in patients with previous pulmonary diseases.…”

Section: Introductionmentioning

confidence: 99%

“…Many factors are involved in the onset of respiratory complications after cardiac surgery, namely, general anesthesia, invasive mechanical ventilation, damage of the surfactant, presence of sternotomy and cardiopulmonary bypass. Diaphragm dysfunction may be related to perioperative phrenic nerve injury, either during harvesting of the internal mammary artery (IMA) or in relation to cold injury caused by local hypothermia [4,10]. Diaphragm ultrasound can be performed at the bedside to assess diaphragm function.…”

Section: Introductionmentioning

confidence: 99%

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Diaphragm Ultrasound in Cardiac Surgery: State of the Art

et al. 2022

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In cardiac surgery, patients are at risk of phrenic nerve injury, which leads to diaphragm dysfunction and acute respiratory failure. Diaphragm dysfunction (DD) is relatively frequent in cardiac surgery and particularly affects patients after coronary artery bypass graft. The onset of DD affects patients’ prognosis in term of weaning from mechanical ventilation and hospital length of stay. The authors present a narrative review about diaphragm physiology, techniques used to assess diaphragm function, and the clinical application of diaphragm ultrasound in patients undergoing cardiac surgery.

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Section: Diaphragm Dysfunction In Icumentioning

confidence: 99%

Section: Diaphragm Dysfunction In Cardiac Surgerymentioning

confidence: 99%

Section: Diaphragm Dysfunction In Cardiac Surgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Diaphragm Ultrasound in Cardiac Surgery: State of the Art

et al. 2022

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Imaging of the Diaphragm Following Cardiac Surgery: Focus on Ultrasonographic Assessment

Rizza

Maranta

Cianfanelli

et al. 2023

J of Ultrasound Medicine

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Diaphragm dysfunction is a common complication following cardiac surgery. Its clinical impact is variable, ranging from the absence of symptoms to the acute respiratory failure. Post‐operative diaphragm dysfunction may negatively affect patients' prognosis delaying the weaning from the mechanical ventilation (MV), extending the time of hospitalization and increasing mortality. Ultrasonography is a valid tool to evaluate diaphragmatic impairment in different settings, like the Intensive Care Unit, to predict successful weaning from the MV, and the Cardiovascular Rehabilitation Unit, to stratify patients in terms of risk of functional recovery failure. The aim of this review is to describe the pathophysiology of post‐cardiac surgery diaphragm dysfunction, the techniques used for its diagnosis and the potential applications of diaphragm ultrasound.

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