Visualized analysis of literature on diaphragm dysfunction and diaphragm-protective ventilation in mechanically ventilated patients

doi:10.3877/cma.j.issn.2096-1537.2026.01.012

Abstract

Abstract:

Objective

To analyze the current research status and development trends in the field of diaphragm dysfunction and diaphragm-protective ventilation in mechanically ventilated patients.

Methods

Literature was retrieved from the Web of Science Core Collection database on January 9, 2025, covering studies published between 2005 and 2024. CiteSpace 6.4 R1 software was used to visualize and analyze the countries/regions, authors, keywords, and research hotspots of the included studies.

Results

A total of 682 articles were included in the analysis. The top three countries by publication volume were the United States (200 articles), Canada (95 articles), and France (94 articles). The most prolific authors were Powers Scott K (55 articles), Martin Dres (34 articles), and Heunks Leo (34 articles). The five most frequently mentioned keywords were "diaphragm dysfunction" (520 times), "mechanical ventilation" (434 times), "ultrasound" (173 times), "frailty" (124 times), and "intensive care unit" (119 times). Burst analysis revealed that recent research emphasizes concepts such as "diaphragm thickening fraction", "critical care", and "invasive mechanical ventilation". Co-citation analysis identified the work of Levine et al. (2008) on diaphragm atrophy mechanisms and Goligher et al. (2018) on clinical translation as pivotal references.

Conclusion

Research on diaphragm-protective ventilation in mechanically ventilated patients is moving from mechanistic exploration to optimizing clinical strategies. However, there are limitations, including the incompleteness of the databases used and a lack of multicenter clinical validation. Future directions should focus on integrating intelligent monitoring technologies, advancing studies on molecular mechanism, and promoting individualized ventilation strategies through interdisciplinary collaboration to achieve synergistic protection of both the lungs and diaphragm.

Key words: Intensive care, Mechanical ventilation, Diaphragmatic dysfunction, Diaphragm protective ventilation, Visual analysis

Dan Hou, Hui Zhang, Jie Zhen, weishuai Bian, Jianxin Zhou, Hongliang Li. Visualized analysis of literature on diaphragm dysfunction and diaphragm-protective ventilation in mechanically ventilated patients[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2026, 12(01): 75-84.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2026.01.012

https://icu.cma-cmc.com.cn/EN/Y2026/V12/I01/75

Figures/Tables 13

References 26

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关键词	频次
膈肌功能障碍（diaphragm dysfunction）	520
机械通气（mechanical ventilation）	434
超声（ultrasound）	173
虚弱（weakness）	124
重症监护室（intensive care unit）	119
膈肌（diaphragm）	105
氧化应激（oxidative stress）	105
骨骼肌（skeletal muscle）	99
影响（impact）	98

关键词	频次
膈肌功能障碍（diaphragm dysfunction）	520
机械通气（mechanical ventilation）	434
超声（ultrasound）	173
虚弱（weakness）	124
重症监护室（intensive care unit）	119
膈肌（diaphragm）	105
氧化应激（oxidative stress）	105
骨骼肌（skeletal muscle）	99
影响（impact）	98

聚类编号	聚类规模	轮廓值	聚类名称	关键词
#0	121	0.742	氧化应激	氧化应激；骨骼肌；钙蛋白酶；蛋白水解；控制机械通气
#1	93	0.772	呼吸机相关性肺损伤	呼吸机相关性肺损伤；急性呼吸窘迫综合征；自主呼吸；保护性通气；呼吸窘迫综合征
#2	90	0.689	超声	超声；氧化应激；脱机；拔管；膈膜增厚分数
#3	71	0.756	重症监护室	重症监护室；获得性无力；肌肉疾病；脱机失败；ICU获得性肌无力
#4	67	0.763	呼吸肌	呼吸肌；茶碱；实验；血流；基因表达
#5	55	0.783	心脏手术	心脏外科；膈肌麻痹；膈膜起搏；膈肌膨出；刺激
#6	18	0.916	肌凝蛋白	肌球蛋白；肌节长度；年龄；热休克蛋白；抑制剂
#7	8	0.972	重症监护	重症监护；计算机化决策支持；临床决策支持；住院康复；呼吸机
#8	6	0.994	一氧化氮	一氧化碳；疲劳；骨骼肌；机械通气；膜片
#9	6	0.987	膈肌力量	膈肌力量；电刺激；膈肌压力；大鼠膈肌；机械通气
#10	5	0.995	诱导细胞凋亡	诱导细胞凋亡；类固醇肌病；地塞米松；心脏手术；糖皮质激素

聚类编号	聚类规模	轮廓值	聚类名称	关键词
#0	121	0.742	氧化应激	氧化应激；骨骼肌；钙蛋白酶；蛋白水解；控制机械通气
#1	93	0.772	呼吸机相关性肺损伤	呼吸机相关性肺损伤；急性呼吸窘迫综合征；自主呼吸；保护性通气；呼吸窘迫综合征
#2	90	0.689	超声	超声；氧化应激；脱机；拔管；膈膜增厚分数
#3	71	0.756	重症监护室	重症监护室；获得性无力；肌肉疾病；脱机失败；ICU获得性肌无力
#4	67	0.763	呼吸肌	呼吸肌；茶碱；实验；血流；基因表达
#5	55	0.783	心脏手术	心脏外科；膈肌麻痹；膈膜起搏；膈肌膨出；刺激
#6	18	0.916	肌凝蛋白	肌球蛋白；肌节长度；年龄；热休克蛋白；抑制剂
#7	8	0.972	重症监护	重症监护；计算机化决策支持；临床决策支持；住院康复；呼吸机
#8	6	0.994	一氧化氮	一氧化碳；疲劳；骨骼肌；机械通气；膜片
#9	6	0.987	膈肌力量	膈肌力量；电刺激；膈肌压力；大鼠膈肌；机械通气
#10	5	0.995	诱导细胞凋亡	诱导细胞凋亡；类固醇肌病；地塞米松；心脏手术；糖皮质激素

聚类编号	规模	轮廓值	主题标签	平均年份
#0	105	0.844	膈肌超声	2019
#1	105	0.807	呼吸机相关性膈肌功能障碍	2012
#2	100	0.941	膈肌保护性通气	2017
#3	97	0.833	膈肌功能障碍	2014
#4	74	0.932	床旁复查	2004
#5	31	0.945	严重弥漫性损伤	2009
#6	29	0.979	缺氧诱导因子	2019
#7	28	0.968	超声评估检查	2020
#8	25	0.966	早产儿	2017
#9	24	0.940	基于肌联蛋白的机械感知	2006

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