Treatment of Diaphragmatic Paralysis: When Is Invasive Mechanical Ventilation Required?
Diaphragmatic paralysis results in loss of the diaphragm's primary role in breathing, which can progress from manageable dysfunction to severe respiratory compromise requiring active ventilatory support.
Clinical Situation
In cases of diaphragmatic paralysis, respiratory support needs depend on the degree of diaphragmatic dysfunction and the trajectory of the underlying condition. As diaphragmatic function worsens, non-invasive approaches may become insufficient to maintain adequate ventilation.
Treatment Approach (partial — see full protocol)
Management involves ventilatory support, with the mode of intervention determined by severity. In more advanced or progressive presentations, invasive mechanical ventilation is among the interventions addressed in the structured protocol — the complete algorithm, indications, and clinical decision criteria are available in full below.
References
DOI: 10.1183/20734735.0218-2024
Ventilatory support can be provided in the form of NIV or as invasive mechanical ventilation (in more severe cases of diaphragmatic dysfunction or when diseases progress and diaphragmatic function worsens meaning NIV is insufficient).