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Critical Care
Published in: Critical Care 1/2020

Open Access 01-12-2020 | Review

Physiology of the Respiratory Drive in ICU Patients: Implications for Diagnosis and Treatment

Authors: Annemijn H. Jonkman, Heder J. de Vries, Leo M. A. Heunks

Published in: Critical Care | Issue 1/2020

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Abstract

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://​www.​biomedcentral.​com/​collections/​annualupdate2020​. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://​www.​springer.​com/​series/​8901.
Literature
1.
De Vries H, Jonkman A, Shi ZH, Spoelstra-De Man A, Heunks L. Assessing breathing effort in mechanical ventilation: physiology and clinical implications. Ann Transl Med. 2018;6:387.PubMedPubMedCentralCrossRef
2.
3.
Telias I, Brochard L, Goligher EC. Is my patient’s respiratory drive (too) high? Intensive Care Med. 2018;44:1936–9.PubMedCrossRef
4.
5.
Dres M, Goligher EC, Heunks LMA, Brochard LJ. Critical illness-associated diaphragm weakness. Intensive Care Med. 2017;43:1441–52.PubMedCrossRef
6.
7.
Tobin M, Gardner W. Monitoring the control of breathing. In: Tobin M, editor. Principles and practice of intensive care monitoring. New York: McGraw-Hill; 1998. p. 415–64.
8.
Petit JM, Milic-Emili J, Delhez L. Role of the diaphragm in breathing in conscious normal man: an electromyographic study. J Appl Physiol (1985). 1969;15:1101–6.CrossRef
9.
Pellegrini M, Hedenstierna G, Roneus A, Segelsjö M, Larsson A, Perchiazzi G. The diaphragm acts as a brake during expiration to prevent lung collapse. Am J Respir Crit Care Med. 2017;195:1608–16.PubMedCrossRef
10.
Doorduin J, Roesthuis LH, Jansen D, Van Der Hoeven JG, Van Hees HWH, Heunks LMA. Respiratory muscle effort during expiration in successful and failed weaning from mechanical ventilation. Anesthesiology. 2018;129:490–501.PubMedCrossRef
11.
Shi ZH, Jonkman A, De Vries H, et al. Expiratory muscle dysfunction in critically ill patients: towards improved understanding. Intensive Care Med. 2019;45:1061–71.PubMedPubMedCentralCrossRef
12.
Coates EL, Li A, Nattie EE. Widespread sites of brain stem ventilatory chemoreceptors. J Appl Physiol (1985). 1993;75:5–14.PubMedCrossRef
13.
Nielsen M, Smith H. Studies on the regulation of respiration in acute hypoxia: preliminary report. Acta Physiol Scand. 1951;22:44–6.PubMedCrossRef
14.
Prabhakar NR, Peng YJ. Peripheral chemoreceptors in health and disease. J Appl Physiol (1985). 2004;96:359–66.PubMedCrossRef
15.
Biscoe TJ, Purves MJ, Sampson SR. Frequency of nerve impulses in single carotid body chemoreceptor afferent fibres recorded in vivo with intact circulation. J Physiol. 1970;208:121–31.PubMedPubMedCentralCrossRef
16.
Coleridge JCG, Coleridge HM. Afferent vagal c fibre innervation of the lungs and airways and its functional significance. Rev Physiol Biochem Pharmacol. 1984;99:2–110.
17.
18.
Leitch AG, Mclennan JE, Balkenhol S, Mclaurin RL, Loudon RG. Ventilatory response to transient hyperoxia in head injury hyperventilation. J Appl Physiol (1985). 1980;49:52–8.CrossRef
19.
Yoshida T, Nakahashi S, Nakamura MAM, et al. Volume-controlled ventilation does not prevent injurious inflation during spontaneous effort. Am J Respir Crit Care Med. 2017;196:590–601.PubMedCrossRef
20.
Yoshida T, Torsani V, Gomes S, et al. Spontaneous effort causes occult pendelluft during mechanical ventilation. Am J Respir Crit Care Med. 2013;188:1420–7.PubMedCrossRef
21.
Brochard L, Slutsky A, Pesenti A. Mechanical ventilation to minimize progression of lung injury in acute respiratory failure. Am J Respir Crit Care Med. 2017;195:438–42.PubMedCrossRef
22.
Hooijman PE, Beishuizen A, Witt CC, et al. Diaphragm muscle fiber weakness and ubiquitin-proteasome activation in critically ill patients. Am J Respir Crit Care Med. 2015;191:1126–38.PubMedPubMedCentralCrossRef
23.
Goligher EC, Fan E, Herridge MS, et al. Evolution of diaphragm thickness during mechanical ventilation. Impact of inspiratory effort. Am J Respir Crit Care Med. 2015;192:1080–8.PubMedCrossRef
24.
Gea J, Zhu E, Gáldiz JB, et al. Functional consequences of eccentric contractions of the diaphragm. Arch Bronconeumol. 2008;45:68–74.
25.
Schmidt M, Banzett RB, Raux M, et al. Unrecognized suffering in the ICU: addressing dyspnea in mechanically ventilated patients. Intensive Care Med. 2014;40:1–10.PubMedCrossRef
26.
Schmidt M, Kindler F, Gottfried SB, et al. Dyspnea and surface inspiratory electromyograms in mechanically ventilated patients. Intensive Care Med. 2013;39:1368–76.PubMedCrossRef
27.
Demoule A, Jung B, Prodanovic H, et al. Diaphragm dysfunction on admission to the intensive care unit. Prevalence, risk factors, and prognostic impact—a prospective study. Am J Respir Crit Care Med. 2013;188:213–9.PubMedCrossRef
28.
Goligher EC, Dres M, Fan E, et al. Mechanical ventilation-induced diaphragm atrophy strongly impacts clinical outcomes. Am J Respir Crit Care Med. 2018;197:204–13.PubMedCrossRef
29.
Epstein SK. How often does patient-ventilator asynchrony occur and what are the consequences? Respir Care. 2011;56:25–38.PubMedCrossRef
30.
Costa R, Navalesi P, Cammarota G, et al. Remifentanil effects on respiratory drive and timing during pressure support ventilation and neurally adjusted ventilatory assist. Respir Physiol Neurobiol. 2017;244:10–6.PubMedCrossRef
31.
Sinderby C, Navalesi P, Beck J, et al. Neural control of mechanical ventilation in respiratory failure. Nat Med. 1999;5:1433–6.PubMedCrossRef
32.
Sinderby C, Beck J, Spahija J, Weinberg J, Grassino AE. Voluntary activation of the human diaphragm in health and disease. J Appl Physiol. 1998;86:2146–58.CrossRef
33.
Beck J, Sinderby C, Lindstrom LH, Grassino AE. Influence of bipolar esophageal electrode positioning on measurements of human crural diaphragm electromyogram. J Appl Physiol. 1996;81:1434–49.PubMedCrossRef
34.
Jansen D, Jonkman AH, Roesthuis L, et al. Estimation of the diaphragm neuromuscular efficiency index in mechanically ventilated critically ill patients. Crit Care. 2018;22:238.PubMedPubMedCentralCrossRef
35.
Jolley CJ, Luo YM, Steier J, Rafferty GF, Polkey MI, Moxham J. Neural respiratory drive and breathlessness in COPD. Eur Respir J. 2015;45:301–4.CrossRef
36.
Whitelaw WA, Derenne J-P, Milic-Emili J. Occlusion pressure as a measure of respiratory center output in conscious man. Respir Physiol. 1975;23:181–99.PubMedCrossRef
37.
Holle R, Schoene R, Pavlin E. Effect of respiratory muscle weakness on p0.1 induced by partial curarization. J Appl Physiol. 1984;57:1150–7.PubMedCrossRef
38.
Conti G, Cinnella G, Barboni E, Lemaire F, Harf A, Brochard L. Estimation of occlusion pressure during assisted ventilation in patients with intrinsic PEEP. Am J Respir Crit Care Med. 1996;154:907–12.PubMedCrossRef
39.
Telias I, Damiani F, Brochard L. The airway occlusion pressure (p0.1) to monitor respiratory drive during mechanical ventilation: increasing awareness of a not-so-new problem. Intensive Care Med. 2018;44:1532–5.PubMedCrossRef
40.
Rittayamai N, Beloncle F, Goligher EC, et al. Effect of inspiratory synchronization during pressure-controlled ventilation on lung distension and inspiratory effort. Ann Intensive Care. 2017;7:100.PubMedPubMedCentralCrossRef
41.
Alberti A, Gallo F, Fongaro A, Valenti S, Rossi A. P0.1 is a useful parameter in setting the level of pressure support ventilation. Intensive Care Med. 1995;21:547–53.PubMedCrossRef
42.
Mancebo J, Albaladejo P, Touchard D, et al. Airway occlusion pressure to titrate positive end-expiratory pressure in patients with dynamic hyperinflation. Anesthesiology. 2000;93:81–90.PubMedCrossRef
43.
Vivier E, Mekontso Dessap A, Dimassi S, et al. Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation. Intensive Care Med. 2012;38:796–803.PubMedCrossRef
44.
45.
Carteaux G, Cordoba-Izquierdo A, Lyazidi A, Heunks L, Thille AW, Brochard L. Comparison between neurally adjusted ventilatory assist and pressure support ventilation levels in terms of respiratory effort. Crit Care Med. 2016;44:503–11.PubMedCrossRef
46.
Doorduin J, Sinderby C, Beck J, Van Der Hoeven JG, Heunks L. Assisted ventilation in patients with acute respiratory distress syndrome. Anesthesiology. 2015;123:181–90.PubMedCrossRef
47.
Vaschetto R, Cammarota G, Colombo D, et al. Effects of propofol on patient-ventilator synchrony and interaction during pressure support ventilation and neurally adjusted ventilatory assist. Crit Care Med. 2014;42:74–82.PubMedCrossRef
48.
Doorduin J, Nollet JL, Roesthuis LH, et al. Partial neuromuscular blockade during partial ventilatory support in sedated patients with high tidal volumes. Am J Respir Crit Care Med. 2017;195:1033–42.PubMedCrossRef
49.
50.
Crotti S, Bottino N, Spinelli E. Spontaneous breathing during veno-venous extracorporeal membrane oxygenation. J Thorac Dis. 2018;10(Suppl 5):S661–S9.PubMedPubMedCentralCrossRef
Metadata
Title
Physiology of the Respiratory Drive in ICU Patients: Implications for Diagnosis and Treatment
Authors
Annemijn H. Jonkman
Heder J. de Vries
Leo M. A. Heunks
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-020-2776-z

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