Interactive effects of corticosteroid and mechanical ventilation on diaphragm muscle function

Sassoon, Catherine S. H.; Zhu, Ercheng; Fang, Liwei; Ramar, Kannan; Jiao, Guangyu; Caiozzo, Vincent J.

doi:10.1002/mus.21821

Cited by 19 publications

(20 citation statements)

References 31 publications

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“…IGF1 levels also showed negative correlation with the amount of myofiber injury in the diaphragm, suggesting a protective effect of IGF1 on myofibers during sepsis (26). A second study compared IGF1 expression in the diaphragmatic muscle of rabbits treated with controlled mechanical ventilation (complete diaphragm muscle inactivity) vs. assisted mechanical ventilation (partial maintenance of neural activation and mechanical loading) (27). The authors observed significantly reduced IGF1 mRNA levels with controlled mechanical ventilation, decreasing expression by 65%.…”

Section: Discussionmentioning

confidence: 99%

IGF1 and IGFBP3 in acute respiratory distress syndrome

Ahasic¹,

Zhai²,

Su³

et al. 2012

European Journal of Endocrinology

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Objective Insulin-like growth factor-1 (IGF1) and its most abundant binding protein, insulin-like growth factor binding protein-3 (IGFBP3), have been implicated in fibrotic lung diseases and persistent acute respiratory distress syndrome (ARDS) because of profibrogenic and antiapoptotic activity. Whether levels of circulating IGF1 and IGFBP3 are altered in ARDS, and whether they predict progression of and survival from ARDS remains unknown. This study aims to characterize circulating levels of IGF1 and IGFBP3 in patients at risk for ARDS in relation to (1) development of ARDS, and (2) mortality among ARDS cases. Design In this case-cohort study, consecutive patients with risk factors for ARDS admitted to the intensive care unit (ICU) were enrolled and followed prospectively for development of ARDS. Cases were followed for all-cause mortality through Day 60. Of 2397 patients enrolled in the parent study, plasma samples were available in 531 (22%) patients (356 controls, 175 cases) from early in presentation. Total plasma IGF1 and IGFBP3 were measured. Results After adjusting for relevant clinical covariates including severity of illness, IGF1 and IGFBP3 levels were significantly lower in ARDS cases than controls (odds ratio [OR], 0.58; P =0.006; OR, 0.57; P=0.0015, respectively). Among ARDS cases, IGF1 and IGFBP3 levels were significantly lower in the 78 (45%) non-survivors (hazard ratio [HR], 0.70; P =0.024; HR, 0.69; P=0.021, respectively). Conclusions Lower levels of circulating IGF1 and IGFBP3 were independently associated with ARDS case status. Furthermore, lower levels were associated with mortality among ARDS cases. This data supports a role of the IGF pathway in ARDS.

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Section: Discussionmentioning

confidence: 99%

IGF1 and IGFBP3 in acute respiratory distress syndrome

Ahasic¹,

Zhai²,

Su³

et al. 2012

European Journal of Endocrinology

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“…For example, Maes et al (61) reported that, during full support MV, the impact of corticosteroids on VIDD in rats is dose dependent with high doses of corticosteroids (i.e., 30 mg/kg) providing partial protection against VIDD, whereas a lower dose (i.e., 5 mg/kg) exacerbates VIDD. In contrast, Sassoon et al (95) reports that high-dose glucocorticoid administration (i.e., 60 mg/kg) does not protect or exacerbate VIDD in rabbits during full support MV, but this dose of corticosteroids produces deleterious effects to the diaphragm during partial support MV. The reason(s) for the divergent findings in these studies are unclear but could be due to a species difference in the response to corticosteroids.…”

Section: Impact Of Age and Drugs On Mv-induced Diaphragmatic Contractmentioning

confidence: 90%

Ventilator-induced diaphragm dysfunction: cause and effect

Powers

Wiggs

Sollanek

et al. 2013

American Journal of Physiology-Regulatory, Integrative and Comp

143

156

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Powers SK, Wiggs MP, Sollanek KJ, Smuder AJ. Ventilator-induced diaphragm dysfunction: cause and effect. Am J Physiol Regul Integr Comp Physiol 305: R464 -R477, 2013. First published July 10, 2013 doi:10.1152/ajpregu.00231.2013 is used clinically to maintain gas exchange in patients that require assistance in maintaining adequate alveolar ventilation. Common indications for MV include respiratory failure, heart failure, drug overdose, and surgery. Although MV can be a life-saving intervention for patients suffering from respiratory failure, prolonged MV can promote diaphragmatic atrophy and contractile dysfunction, which is referred to as ventilator-induced diaphragm dysfunction (VIDD). This is significant because VIDD is thought to contribute to problems in weaning patients from the ventilator. Extended time on the ventilator increases health care costs and greatly increases patient morbidity and mortality. Research reveals that only 18 -24 h of MV is sufficient to develop VIDD in both laboratory animals and humans. Studies using animal models reveal that MV-induced diaphragmatic atrophy occurs due to increased diaphragmatic protein breakdown and decreased protein synthesis. Recent investigations have identified calpain, caspase-3, autophagy, and the ubiquitin-proteasome system as key proteases that participate in MV-induced diaphragmatic proteolysis. The challenge for the future is to define the MV-induced signaling pathways that promote the loss of diaphragm protein and depress diaphragm contractility. Indeed, forthcoming studies that delineate the signaling mechanisms responsible for VIDD will provide the knowledge necessary for the development of a pharmacological approach that can prevent VIDD and reduce the incidence of weaning problems. respiratory muscle; atrophy; mechanical ventilation; weaning; muscle wasting MECHANICAL VENTILATION (MV) is used clinically to achieve sufficient pulmonary gas exchange in patients unable to sustain adequate alveolar ventilation on their own. Common indications for MV include respiratory failure due to chronic obstructive pulmonary disease, status asthmaticus, and/or heart failure. In addition, MV is often an essential intervention in patients suffering from acute drug overdose, neuromuscular diseases, sepsis, and during surgery along with postsurgical recovery.The number of patients receiving prolonged MV in the United States exceeds more than 300,000 each year in the intensive care unit (ICU) (20). Although MV can be a lifesaving measure, prolonged MV results in the rapid development of diaphragmatic weakness due to both atrophy and contractile dysfunction. This detrimental impact of prolonged MV on the diaphragm has been termed ventilator-induced diaphragmatic dysfunction (VIDD) and VIDD is predicted to be a major contributor to problems in weaning patients from the ventilator (26, 114). Although previous reports describing the impact of prolonged MV on the diaphragm have appeared in the literature, advances in our understanding of the mechanisms responsible for VIDD h...

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“…It is worth noting that recent studies suggest that corticosteroid treatment (usually high-dose, short duration) may mitigate the deleterious effects of controlled mechanical ventilation on DIAm structural and functional properties (Maes et al, 2010; Maes et al, 2008; Sassoon et al, 2011). The mechanisms underlying such an effect remain unclear but may include effects on lung injury (and the resultant systemic inflammatory response) or nutritional status in addition to direct effects on the DIAm.…”

Section: Diseases and Conditions Resulting In Selective Diam Fibermentioning

confidence: 99%

Impact of diaphragm muscle fiber atrophy on neuromotor control

Mantilla

Sieck

2013

Respiratory Physiology & Neurobiology

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In skeletal muscles, motor units comprise a motoneuron and the group of muscle fibers innervated by it, which are usually classified based on myosin heavy chain isoform expression. Motor units displaying diverse contractile and fatigue properties are important in determining the range of motor behaviors that can be accomplished by a muscle. Muscle fiber atrophy and weakness may disproportionately affect specific fiber types across a variety of diseases or clinical conditions, thus impacting neuromotor control. In this regard, fiber atrophy that affects a specific fiber type will alter the relative contribution of different motor units to overall muscle structure and function. For example, in various diseases there is fairly selective atrophy of type IIx and/or IIb fibers comprising the strongest yet most fatigable motor units. As a result, there is muscle weakness (i.e., reductions in force per cross-sectional area) associated with an apparent improvement in resistance to fatiguing contractions. This review will examine neuromotor control of respiratory muscles such as the diaphragm muscle and the impact of muscle fiber atrophy on motor performance.

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Interactive effects of corticosteroid and mechanical ventilation on diaphragm muscle function

Cited by 19 publications

References 31 publications

IGF1 and IGFBP3 in acute respiratory distress syndrome

IGF1 and IGFBP3 in acute respiratory distress syndrome

Ventilator-induced diaphragm dysfunction: cause and effect

Impact of diaphragm muscle fiber atrophy on neuromotor control

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