Diaphragm stimulation in critically ill patients: what do we know, and what do we still need to learn?

Diaphragm weakness is a common complication in critically ill patients and can develop within days after the initiation of invasive mechanical ventilation.^(,) It is characterized by a rapid loss of diaphragm contractile capacity, which compromises the patient’s ability to breathe independently.^(,) Diaphragm weakness is strongly associated with worse clinical outcomes, including prolonged weaning from mechanical ventilation (MV), longer intensive care unit (ICU) and hospital length of stay, and higher mortality.^(-) Because of its high prevalence and major clinical impact, substantial efforts have focused on identifying strategies and interventions to prevent or reverse diaphragm weakness and dysfunction, such as inspiratory muscle training, early mobilization, and diaphragm electrical stimulation.^(-)