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Mechanical Ventilators: From Breathing Help to Breathing Handicap

Researchers explore cell-level changes that weaken the diaphragm after prolonged ventilator use 

Tampa, Fla. (September 10, 2015)—Mechanical ventilators are routinely used in both surgical and emergency situations every day in U.S. hospitals. These machines breathe for the patient when they are unable to do so, and it is estimated that nearly 800,000 hospitalized patients need ventilators each year. Though often life saving in the short term, prolonged use of ventilators can lead to diaphragm weakness, and problems commonly arise—roughly 20 to 30 percent of the time—when weaning the patient off the ventilator. In findings presented today at the Physiological Bioenergetics: From Bench to Bedside conference, researchers at the University of Florida provide insights into what causes the weakness on a cellular level. This information could lead to strategies that hospitals can use to help prevent ventilator-related diaphragm damage. 

The research team’s previous research linked weakness in the diaphragm to dysfunction in the cell’s mitochondria—the cell’s source of energy generation—and the production of reactive oxygen species. “This results in oxidative damage to diaphragm proteins, leading to increased breakdown of proteins in the diaphragm and wasting (atrophy) of the fibers in the diaphragm,” said Ashley Smuder, PhD, lead author on the study.

“The goal of this study was to determine the effects of mechanical ventilation-induced activation of the autophagy/lysosomal system on ventilator-induced diaphragm mitochondrial dysfunction,” Smuder said. “Our results demonstrate that inhibiting autophagy during mechanical ventilation can reduce mitochondrial dysfunction and prevent diaphragm atrophy and contractile dysfunction.”

Smuder, of the University of Florida, will present “Increased autophagy is required for mechanical ventilation-induced diaphragm mitochondrial dysfunction” during a poster session on Thursday, Sept. 10, at 5:30 PM EDT at the Westin Tampa Harbour Island.

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Physiology is the study of how molecules, cells, tissues and organs function in health and disease. Established in 1887, the American Physiological Society (APS) was the first U.S. society in the biomedical sciences field. The Society represents more than 10,500 members and publishes 15 peer-reviewed journals with a worldwide readership.