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Critical Care Reviews |

Clinical Aspects of Respiratory Muscle Dysfunction in the Critically Ill*

Michael I. Polkey, PhD; John Moxham, MD
Author and Funding Information

*From the Respiratory Muscle Laboratory (Dr. Polkey), Royal Brompton Hospital, National Heart & Lung Institute, London, UK; and Respiratory Muscle Laboratory (Dr. Moxham), Kings College Hospital, Guy’s, Kings & St. Thomas School of Medicine, London, UK.

Correspondence to: Michael I. Polkey, MD, Respiratory Muscle Laboratory, Royal Brompton Hospital, Fulham Rd, London SW3 6NP, UK; e-mail m.polkey@rbh.nthames.nhs.uk



Chest. 2001;119(3):926-939. doi:10.1378/chest.119.3.926
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When the load placed on the respiratory muscle pump exceeds its capacity, ventilatory failure ensues. This situation is ultimately fatal unless either medical therapy is able to reduce the load or mechanical ventilation is instituted. Preexisting neuromuscular disease is sometimes the primary indication for mechanical ventilation, but the more usual indications, at least in the general ICU setting, are nonneurologic causes, for example, trauma, surgery, and sepsis, in patients not previously known to have neurologic disease.

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