<p>Besides ventilator-induced lung injury (VILI), attention is being paid increasingly more to the negative effects of mechanical ventilation on the diaphragm, the main respiratory muscle (ventilator-induced diaphragmatic dysfunction, VIDD). Furthermore, patient-ventilator interactions can lead to asynchrony that may impair diaphragm function as well. According to current findings, patient outcomes appear to be significantly affected by these phenomena. Although research in this field has made major achievements in recent years, the translation of this knowledge into clinical practice remains incomplete. This review therefore summarizes the current understanding of VIDD and proposes some practical techniques for recognition, prevention and treatment of VIDD, approaches that are feasible in every intensive care unit.</p>