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Abstract
Information about respiratory muscle dysfunction in critically ill patients was almost not existent till recent time ;several new syndromes have been described and research on the effect of sepsis has become one of the fastest growing areas.Research on the molecular basis of neuromuscular disorders had hardely commenced and understanding in this field has accelerated rapidly.Significant advances have also occurred in the stable entities of obstructive lung disease,heart failure , and spinal cord injury.Better understanding of pathophysiologic mechanisms, however ,has not been accompanied by significant improvements in every day diagnostic techniques. Respiratory muscle function is monitored at a rudimentary level in routine critical care practice.Stagnation in diagnostic and monitoring techniques may have steemed from the paucity of new therapies directed at the respiratory muscles. Together these advances should motivate the introduction of more advanced diagnosic and monitoring techniques into everyday clinical practice.Disappointingly,the gap between basic understanding of pathophysiologic mechanisms and the translation of this knowledge into improvements in patient outcome has widened over the last 25 years. It is hoped that this gap will be narrowed by time .