Nurse holding hand of patient on ventilator
Of the more than 230,000 patients annually admitted to intensive care units in Canada, around one-third receive invasive ventilation. (Photo: iStock)

Hospital intensive care units attend to patients with life-threatening or critical conditions. A stay there can be devastating, and patients who are released are often severely weakened and may experience long-term disabilities.

"Identifying patients who will have serious difficulties recovering from illness is a challenge," says Dr. Ewan Goligher, a Scientist with Toronto General Hospital Research Institute.

Prompted by this challenge, Dr. Goligher and his team initiated a study that focused on patients being aided by a breathing machine – a procedure also known as invasive ventilation. In this procedure, a breathing tube is inserted into the throat so that air can be mechanically pumped into and out of the lungs to help the patient breathe.

In their study, the researchers examined patients who had received invasive ventilation at hospitals in Toronto and tracked their recovery. The researchers measured the thickness of patients' diaphragms – the primary muscle used for breathing – using ultrasound imaging.

The study results revealed that the patients with more muscle mass in their diaphragms when first admitted had a lower risk of death in hospital. As well, they were less likely to develop complications and recovered from respiratory assistance significantly faster.

While the results may help identify the patients who are at risk for poor recovery, they could also enable the development of new, proactive approaches to reducing these risks. In cases where doctors can foresee a patient needing ventilation, such as following organ transplant or for serious illnesses like cancer, exercises aimed at strengthening the diaphragm could be prescribed.

This work was supported by the Canadian Institutes of Health Research and Toronto General & Western Hospital Foundation.

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