Can "Awake Extracorporeal Life Support" Prevent Ventilator-Induced Diaphragm Atrophy and Injury in Patients with Acute on Chronic Respiratory Failure?

The diaphragm is the main breathing muscle. Patients with diaphragm weakness experience serious difficulties with breathing and exercise. A strong diaphragm makes patients more resilient to acute respiratory problems and maintaining diaphragm strength in respiratory failure patients is vitally important to help patients recover from lung failure due to pneumonia, Covid-19, and other lung diseases. Being on a ventilator for lung failure can cause diaphragm weakness; this might be prevented by a different form of artificial lung support that avoids the need for the breathing machine. In patients who require artificial lung support before transplantation, we will study diaphragm tissue obtained during the transplant surgery to determine whether the use of artificial lung support can avoid the loss of diaphragm muscle bulk and reduce the amount of diaphragm muscle injury that occurs with the artificial breathing machine. Answers to these questions will lead to new methods for treating patients with lung failure focused on improving and maintaining diaphragm muscle bulk and strength. These methods will enable us to improve recovery and quality of life for patients with acute and chronic lung diseases.