{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:49:15Z","timestamp":1792226955317,"version":"4.4.0"},"reference-count":107,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support","award":["XMLX202106"],"award-info":[{"award-number":["XMLX202106"]}]},{"name":"Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support","award":["CYFH202205"],"award-info":[{"award-number":["CYFH202205"]}]},{"name":"Clinical Research Incubation Project of Beijing Chaoyang Hospital, Capital Medical University","award":["XMLX202106"],"award-info":[{"award-number":["XMLX202106"]}]},{"name":"Clinical Research Incubation Project of Beijing Chaoyang Hospital, Capital Medical University","award":["CYFH202205"],"award-info":[{"award-number":["CYFH202205"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Diaphragm Dysfunction (DD) is a respiratory disorder with multiple causes. Although both unilateral and bilateral DD could ultimately lead to respiratory failure, the former is more common. Increasing research has recently delved into perioperative diaphragm protection. It has been established that DD promotes atelectasis development by affecting lung and chest wall mechanics. Diaphragm function must be specifically assessed for clinicians to optimally select an anesthetic approach, prepare for adequate monitoring, and implement the perioperative plan. Recent technological advancements, including dynamic MRI, ultrasound, and esophageal manometry, have critically aided disease diagnosis and management. In this context, it is noteworthy that therapeutic approaches for DD vary depending on its etiology and include various interventions, either noninvasive or invasive, aimed at promoting diaphragm recruitment. This review aims to unravel alternative anesthetic and operative strategies that minimize postoperative dysfunction by elucidating the identification of patients at a higher risk of DD and procedures that could cause postoperative DD, facilitating the recognition and avoidance of anesthetic and surgical interventions likely to impair diaphragmatic function.<\/jats:p>","DOI":"10.3390\/jcm13020519","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T04:16:56Z","timestamp":1705465016000},"page":"519","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Perioperative Diaphragm Dysfunction"],"prefix":"10.3390","volume":"13","author":[{"given":"Jinge","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China"},{"name":"Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruijuan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9316-4087","authenticated-orcid":false,"given":"Huili","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0695-8861","authenticated-orcid":false,"given":"Yun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.ccm.2018.01.012","article-title":"Disorders of the diaphragm","volume":"39","author":"McCool","year":"2018","journal-title":"Clin. 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