American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jun 2017
The Diaphragm Acts as a Brake During Expiration to Prevent Lung Collapse.
The diaphragm is the major inspiratory muscle and is assumed to relax during expiration. However, electrical postinspiratory activity has been observed. Whether there is an expiratory diaphragmatic contraction that preserves lung patency has yet to be explored. ⋯ The diaphragm is an important regulator of expiration. Its expiratory activity seems to preserve lung volume and to protect against lung collapse. The loss of diaphragmatic expiratory contraction during mechanical ventilation and muscle paralysis may be a contributing factor to unsuccessful respiratory support.
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Am. J. Respir. Crit. Care Med. · Jun 2017
Outcomes After Rehospitalization at the Same Hospital or a Different Hospital Following Critical Illness.
Intensive care unit (ICU) patients who receive mechanical ventilation are at high risk for early rehospitalization. Given the medical complexity of these patients, a lack of continuity of care may adversely affect their outcomes during rehospitalization. ⋯ Almost one-third of mechanically ventilated critically ill patients were rehospitalized at a different hospital than that of the index ICU stay. This care discontinuity was associated with increased mortality.