Phrenic nerve stimulation protects against mechanical ventilation-induced diaphragm dysfunction in rats

2013 ◽  
Vol 48 (6) ◽  
pp. 958-962 ◽  
Author(s):  
Meirong Yang ◽  
Haitao Wang ◽  
Guangwei Han ◽  
Lianhua Chen ◽  
Lina Huang ◽  
...  
2014 ◽  
Vol 106 (2) ◽  
pp. 766a
Author(s):  
Bumsoo Ahn ◽  
Daniel Martin ◽  
Tomas Martin ◽  
Tom Beaver ◽  
Barbara Smith ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michal Soták ◽  
Karel Roubík ◽  
Tomáš Henlín ◽  
Tomáš Tyll

Abstract Background Diaphragm atrophy and dysfunction is a major problem among critically ill patients on mechanical ventilation. Ventilator-induced diaphragmatic dysfunction is thought to play a major role, resulting in a failure of weaning. Stimulation of the phrenic nerves and resulting diaphragm contraction could potentially prevent or treat this atrophy. The subject of this study is to determine the effectiveness of diaphragm stimulation in preventing atrophy by measuring changes in its thickness. Methods A total of 12 patients in the intervention group and 10 patients in the control group were enrolled. Diaphragm thickness was measured by ultrasound in both groups at the beginning of study enrollment (hour 0), after 24 hours, and at study completion (hour 48). The obtained data were then statistically analyzed and both groups were compared. Results The results showed that the baseline diaphragm thickness in the interventional group was (1.98 ± 0.52) mm and after 48 hours of phrenic nerve stimulation increased to (2.20 ± 0.45) mm (p=0.001). The baseline diaphragm thickness of (2.00 ± 0.33) mm decreased in the control group after 48 hours of mechanical ventilation to (1.72 ± 0.20) mm (p<0.001). Conclusions Our study demonstrates that induced contraction of the diaphragm by pacing the phrenic nerve not only reduces the rate of its atrophy during mechanical ventilation but also leads to an increase in its thickness – the main determinant of the muscle strength required for spontaneous ventilation and successful ventilator weaning. Trial registration: The study was registered with ClinicalTrials.gov (18/06/2018, NCT03559933, https://clinicaltrials.gov/ct2/show/NCT03559933).


2020 ◽  
Vol 48 (5) ◽  
pp. e362-e370 ◽  
Author(s):  
James O’Rourke ◽  
Michal Soták ◽  
Gerard F. Curley ◽  
Aoife Doolan ◽  
Tomáš Henlín ◽  
...  

2013 ◽  
Vol 183 (1) ◽  
pp. 149-150 ◽  
Author(s):  
E. Stanley ◽  
J. Broderick ◽  
K. Synnott ◽  
J. McCarthy ◽  
E. Smith ◽  
...  

1989 ◽  
Vol 67 (4) ◽  
pp. 1364-1370 ◽  
Author(s):  
D. F. Speck

Neuronal recordings, microstimulation, and electrolytic and chemical lesions were used to examine the involvement of the Botzinger Complex (BotC) in the bilateral phrenic-to-phrenic inhibitory reflex. Experiments were conducted in decerebrate cats that were paralyzed, ventilated, thoracotomized, and vagotomized. Microelectrode recordings within the BotC region revealed that some neurons were activated by phrenic nerve stimulation (15 of 69 expiratory units, 9 of 67 inspiratory units, and 19 nonrespiratory-modulated units) at average latencies similar to the onset latency of the phrenic-to-phrenic inhibition. In addition, microstimulation within the BotC caused a short latency transient inhibition of phrenic motor activity. In 17 cats phrenic neurogram responses to threshold and supramaximal (15 mA) stimulation of phrenic nerve afferents were recorded before and after electrolytic BotC lesions. In 15 animals the inhibitory reflex was attenuated by bilateral lesions. Because lesion of either BotC neurons or axons of passage could account for this attenuation, in eight experiments the phrenic-to-phrenic inhibitory responses were recorded before and after bilateral injections of 5 microM kainic acid (30–150 nl) into the BotC. After chemical lesions, the inhibitory response to phrenic nerve stimulation remained; however, neuronal activity typical of the BotC could not be located. These results suggest that axons important in producing the phrenic-to-phrenic reflex pass through the region of the BotC, but that BotC neurons themselves are not necessary for this reflex.


2017 ◽  
Vol 40 (3) ◽  
pp. 294-300
Author(s):  
LUKAS R.C. DEKKER ◽  
BART GERRITSE ◽  
AVRAM SCHEINER ◽  
LILIAN KORNET

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