Publications by authors named "M Dres"
Blowing in the Wind: The Uncertain Impact of Inspiratory Muscle Strength Training in ICU Patients.
Am J Respir Crit Care Med
January 2025
Background: The present study was designed to investigate the evolution and the impact of respiratory muscles function and limb muscles strength on weaning success in prolonged weaning of tracheotomized patients. The primary objective was to determine whether the change in respiratory muscles function and limb muscles strength over the time is or is not associated with weaning success.
Methods: Tracheotomized patients who were ventilator dependent upon admission at a weaning center were eligible.
Nasal High Flow to Modulate Dyspnea in Orally Intubated Patients.
Am J Respir Crit Care Med
December 2024
Rationale: High flow therapy reduces dyspnea in acute respiratory failure but the underlying mechanisms are not fully elucidated.
Objectives: To compare dyspnea, airway occlusion pressure (P) and inspiratory work with and without nasal high flow (NHF, FiO 21%, temperature 31°C) in intubated patients under pressure support ventilation and during a spontaneous breathing trial (SBT).
Methods: Dyspnea (numerical rating scale, NRS and Mechanical Ventilation - Respiratory Distress Observational Scale, MV-RDOS), P, esophageal pressure, respiratory muscles EMG, arterial blood gas were compared in intubated patients on pressure support ventilation presenting a dyspnea-NRS > 3 during two sequences: 1) pressure support ventilation with NHF at 0 L/min followed by 30, 50 and 60 L/min (the last three were randomized) and 2) a SBT with NHF at 0 and 50 L/min (randomized).
How to protect the diaphragm and the lung with diaphragm neurostimulation.
Curr Opin Crit Care
February 2025
Purpose Of Review: In the current review, we aim to highlight the evolving evidence on using diaphragm neurostimulation to develop lung and diaphragm protective mechanical ventilation.
Recent Findings: Positive-pressure ventilation (PPV) causes stress and strain to the lungs which leads to ventilator-induced lung injury (VILI). In addition, PPV is frequently associated with sedatives that induce excessive diaphragm unloading which contributes to ventilator-induced diaphragmatic dysfunction (VIDD).
Article Synopsis
- In critically ill patients, deep sedation and mechanical ventilation can lead to cognitive issues by suppressing the brain-diaphragm-lung interactions.
- This study explored whether phrenic nerve stimulation could improve brain activity and connectivity in six patients with acute respiratory distress syndrome.
- Results showed that phrenic stimulation, combined with mechanical ventilation, enhanced brain activity and synchronization similar to what occurs during natural diaphragmatic breathing, indicating its potential to restore important neural communication.