TY - JOUR T1 - VIDD during weaning: Comparison between pressure controlled and pressure support ventilation JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P4921 AU - Ulrike Olgemoeller AU - Wolfgang Koerber AU - Carl-Peter Criée Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P4921.abstract N2 - Background:Mechanical ventilation (MV) is a life-saving treatment in acute respiratory failure. Invasive controlled MV induces diaphragm muscle dysfunction (ventilator-induced diaphragmatic dysfunction, VIDD).The existence of VIDD is scientifically proven in animal models and there is strong evidence for the occurrence of VIDD in humans (Jaber et al. AJRCCM 2011).The purpose of this study was to assess diaphragmatic strength in patients during prolonged weaning being ventilated with different modes.Methods:In 22 patients we measured the endotracheal pressure after bilateral anterior magnetic stimulation of the N. phrenicus (twPet) as an index of diaphragmatic strength. After a 24-hour-period of controlled ventilation we randomized the patients in a group with controlled ventilation (group 1) and a group undergoing ventilatory support in an assisted mode (group 2) during the next 5 days.Results:TwPet at the time of admission was decreased in both groups (group 1: 0,33 kpa; group 2: 0,39 kpa) compared to normal values of Twitch mouth pressure in our laboratory (1,9 kPa). In group 2 twPet increased significantly from 0,39 kpa to 0,66 kpa (p=0,0195*) whereas it shows only a small, not significant (p=0,99) increase in group 1 from 0,33 kpa to 0,35 kpa.Conclusions:In patients who were ventilated in the assisted mode the increasing twPet could indicate a quicker recovery of the diaphragma from VIDD. ER -