Safety and Feasibility of Noninvasive Electromagnetic Stimulation of the Phrenic Nerves.
BACKGROUND: Mechanical ventilation is widely used in ICU patients as a lifesaving intervention. Diaphragmatic atrophy and thinning occur from lack of contractions of the diaphragm during mechanical ventilation. It may prolong weaning and increase the risk of respiratory complications. Noninvasive el...
| Publicado en: | Respiratory Care Vol. 68; no. 5; pp. 602 - 611 |
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| Autores principales: | , , , , , |
| Formato: | equations & formulas pictorial research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
May2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=163323493&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 163323493 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: May2023 vid: 68 iid: 5 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 163323493 163323493 163323493 10.4187/respcare.10568 163323493 ppf: 602 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Safety and Feasibility of Noninvasive Electromagnetic Stimulation of the Phrenic Nerves. aug: au: Mueller, Gabi Aszalos, Elöd Krause, Sven Niederhauser, Thomas Slavei, Krisztina Baumberger, Michael E. affil: Clinical Trial Unit, Swiss Paraplegic Center, Nottwil, Switzerland sug: subj: Phrenic Nerve Physiology Electromagnetics Electric Stimulation Patient Safety Noninvasive Procedures Treatment Outcomes Anesthesia Human Male Female Adult Middle Age Pilot Studies Diaphragm Electromagnetic Fields Equipment and Supplies Health Screening Patient Assessment Descriptive Statistics Outcome Assessment Data Analysis Software Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: BACKGROUND: Mechanical ventilation is widely used in ICU patients as a lifesaving intervention. Diaphragmatic atrophy and thinning occur from lack of contractions of the diaphragm during mechanical ventilation. It may prolong weaning and increase the risk of respiratory complications. Noninvasive electromagnetic stimulation of the phrenic nerves may ameliorate the atrophy seen with ventilation. The objective of this study was to show that noninvasive repetitive electromagnetic stimulation is safe, feasible, and effective to stimulate the phrenic nerves in both awake individuals and anesthetized patients. METHODS: A single-center study with 10 subjects overall, 5 awake volunteers and 5 anesthetized subjects. We used a prototype electromagnetic, noninvasive, simultaneous bilateral phrenic nerve stimulation device in both groups. In the awake volunteers, we assessed time-to-first capture of the phrenic nerves and safety measures, such as pain, discomfort, dental paresthesia, and skin irritation. In the anesthetized subjects, time-to-first capture as well as tidal volumes and airway pressures at 20%, 30%, and 40% stimulation intensity were assessed. RESULTS: Diaphragmatic capture was achieved in all the subjects within a median (range) of 1 min (1 min to 9 min 21 s) for the awake subjects and 30 s (20 s to 1 min 15 s) for the anesthetized subjects. There were no adverse or severe adverse events in either group, nor any dental paresthesia, skin irritation, or subjective pain in the stimulated area. Tidal volumes increased in all the subjects in response to simultaneous bilateral phrenic nerve stimulation and increased gradually with increasing stimulation intensity. Airway pressures corresponded to spontaneous breathing of ~2 cm H2O. CONCLUSIONS: Noninvasive phrenic nerve stimulation can be safely performed in awake and anesthetized individuals. It was feasible and effective in stimulating the diaphragm by induction of physiologic and scalable tidal volumes with minimum positive airway pressures. pubtype: Academic Journal doctype: equations & formulas pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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