What question did this study set out to answer?

To evaluate morphological and functional changes of the diaphragm in patients presenting with decompensated chronic heart failure.

September 19, 2024Russian Journal of Anesthesiology and Reanimatology

Structural, morphological and functional changes of diaphragm in patients with chronic heart failure

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Authors

VSV. S. ShabaevFederal Almazov North-West Medical Research Centre IMIgor MakarovFederal Almazov North-West Medical Research Centre ЛМЛ. Б. МитрофановаFederal Almazov North-West Medical Research Centre

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Implication

Observational study observes diaphragm thickening from edema and muscle hypertrophy in decompensated chronic heart failure, highlighting the need for diaphragm-protective ventilation.

Key Points

To evaluate morphological and functional changes of the diaphragm in patients presenting with decompensated chronic heart failure.
Executed a two-stage study comprising a clinical stage in 10 patients and a postmortem morphological stage in 18 deceased patients.
Assessed clinical diaphragm thickness, thickening fraction, excursion, and spirometry between ICU-discharged patients (n=7) and patients deteriorating to extracorporeal membrane oxygenation (n=3).
Conducted comparative histological analysis of the muscular diaphragm between 11 patients who died from chronic heart failure and 7 who died from other etiologies.
ICU-discharged patients showed reduced right diaphragm thickness from admission to discharge during calm inhalation (0.31 to 0.22 cm, p=0.027) and calm exhalation (0.26 to 0.19 cm, p=0.04), whereas deteriorating patients developed increased thickness (0.27±0.05 to 0.43±0.18 cm) and deteriorated negative inspiratory force (30.0±15.2 to 13.3±3.0 Mbar).
Histological assessment revealed significantly greater diaphragm thickness in heart failure fatalities compared to non-heart failure controls (2.5 vs. 1.6 mm, p=0.006), driven by elevated edema scores (2.0 vs. 0.9 points, p=0.011) and increased transverse muscle fiber diameter (42.0 vs. 34.9 µm, p=0.015).

Cite This Study

Shabaev et al. (2024) studied this question.

synapsesocial.com/papers/6ab0bf0cf76cc45b4c01ab44 https://doi.org/10.17116/anaesthesiology202405188

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Implication

Observational study observes diaphragm thickening from edema and muscle hypertrophy in decompensated chronic heart failure, highlighting the need for diaphragm-protective ventilation.

Structural, morphological and functional changes of diaphragm in patients with chronic heart failure

Discussion

Member takes

Implication

Key Points

Cite This Study

Structural, morphological and functional changes of diaphragm in patients with chronic heart failure

Discussion

Member takes

Implication

Key Points

Cite This Study

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