The Role of Diaphragm Function in Disease

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Abstract
Respiratory failure resulting from impaired function of the diaphragm is being recognized with increasing frequency. However, most clinicians are much more familiar with the neuroanatomical aspects of this muscle than its role in ventilation and gas exchange. Galen learned, by cutting the spinal cord at various levels in experimental pigs, that the diaphragm alone was capable of sustaining life, but a vigorous debate continues to the present day about th( exact contribution of the diaphragm to normal breathing at rest, during exercise, and in disease. In the last two decades several new techniques and concepts have been applied to the evaluation of diaphragm function and management of dysfunction. Most of the conclusions in older literature need to be reviewed in the context of the new data. This review is presented to emphasize clinical implications of new ideas in this area. NORMAL DIAPHRAGM FUNCTION The diaphragm is a contractile membrane attached

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