Assessment of Respiratory Muscle Function in the Intensive Care Unit

Few areas exist in clinical medicine where problems with the respiratory muscles play a greater role than in patients managed in an intensive care unit (ICU). The inability of the respiratory muscles to sustain spontaneous ventilation is the primary indication for the main therapeutic modality of an ICU, namely mechanical ventilation (1). Likewise, respiratory muscle performance is the major issue in deciding the timing and pace with which mechanical ventilation can be discontinued (2, 3). Many tests of respiratory muscle function require a high level of motivation and cooperation, making it much more difficult to obtain reliable measurements in critically ill patients than in an ambulatory-care setting. This section covers the tests of demonstrable, or potential, value that directly, or indirectly, relate to respiratory muscle function in the ICU setting. Consequently, the tests focus predominantly on a patient's need for mechanical ventilation and how this therapeutic modality can be best delivered.

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