Diaphragm pacing

Glenn, William W. L.; Gee, J. Bernard L.; Schachter, E. Neil

doi:10.1016/s0022-5223(19)41299-3

Cited by 25 publications

(2 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Phrenic nerve stimulation to pace the diaphragm is a technique whereby a nerve stimulator provides electrical stimulation of the phrenic nerve to cause diaphragmatic contraction. Before detailing the novel use of diaphragm pacing to prevent VIDD in mechanically ventilated patients in the ICU, it should be acknowledged that diaphragm pacing per se is not a novel therapeutic option: in fact, its first use in humans came in the late 1960s, and then the first phrenic nerve stimulators were made commercially available [24][25][26][27][28][29][30][31][32][33][34]. Although worldwide use is limited, the two main indications for phrenic nerve stimulation were, and still are, central alveolar hypoventilation and high quadriplegia [28][29][30][31][32][33][34].…”

Section: Potential Of Diaphragm Pacing To Prevent Vidd In the Icumentioning

confidence: 99%

State-of-the-Art Opinion Article on Ventilator-Induced Diaphragm Dysfunction: Update on Diagnosis, Clinical Course, and Future Treatment Options

et al. 2022

View full text Add to dashboard Cite

Evidence from both animal and human studies now supports the development of ventilator-induced diaphragm dysfunction (VIDD) starting as early as 24 h after initiation of mechanical ventilation in the intensive care unit (ICU). However, although the concept of VIDD is now widely accepted, there remain several unanswered questions regarding its pathophysiology, rate of development, and (potentially) recovery after mechanical ventilation.This state-of-the-art opinion article briefly explains VIDD and provides an update on its clinical and prognostic relevance. It then focusses on state-of-the-art diagnostic approaches to determine diaphragm function, strength, and control (neural and peripheral), highlights knowledge gaps relevant to VIDD, and discusses the use of diaphragm pacing for VIDD prevention. It is suggested that future research projects in mechanically ventilated patients would ideally use both cortical and cervical phrenic nerve stimulation studies over time (including also diaphragm electromyography) as the gold standard techniques. This approach has not yet been utilized in a longitudinally designed study in the ICU. Application of these gold standard techniques would allow better understanding of the true pathophysiology and rate of development of VIDD. Notably, these techniques would be superior to diaphragm ultrasound, which yields surrogate markers of diaphragm function only without any direct measure of diaphragm strength or control. It is also suggested that such translational research would further advance understanding of diaphragm pacing as a very promising treatment option for VIDD.

show abstract

Section: Potential Of Diaphragm Pacing To Prevent Vidd In the Icumentioning

confidence: 99%

State-of-the-Art Opinion Article on Ventilator-Induced Diaphragm Dysfunction: Update on Diagnosis, Clinical Course, and Future Treatment Options

et al. 2022

View full text Add to dashboard Cite

show abstract

“…[65][66][67][68] Active pacing time has to be gradually advanced before it can support adequate and sustained respiratory performance. 36,69 During this conditioning process, lowfrequency (ie, <20-Hz) stimulation is applied to promote reverse remodeling of the histologic microstructure, converting the diaphragm from the predominant type II fiber structure (ie, atrophy type) into a predominant type I fiber structure (ie, endurance type). Although higher frequencies of approximately 50 Hz can induce greater contraction force, these higher frequencies have been associated with an increased risk of myopathic changes in addition to increasing fatigability.…”

Section: Limitations Of Peripheral Neuro-modulation For Restoring Resmentioning

confidence: 99%

Electrical Neuromodulation of the Respiratory System After Spinal Cord Injury

Hachmann

Grahn

Calvert

et al. 2017

Mayo Clinic Proceedings

View full text Add to dashboard Cite

Spinal cord injury (SCI) is a complex and devastating condition characterized by disruption of descending, ascending, and intrinsic spinal circuitry resulting in chronic neurologic deficits. In addition to limb and trunk sensorimotor deficits, SCI can impair autonomic neurocircuitry such as the motor networks that support respiration and cough. High cervical SCI can cause complete respiratory paralysis, and even lower cervical or thoracic lesions commonly result in partial respiratory impairment. Although electrophrenic respiration can restore ventilator-independent breathing in select candidates, only a small subset of affected individuals can benefit from this technology at this moment. Over the past decades, spinal cord stimulation has shown promise for augmentation and recovery of neurologic function including motor control, cough, and breathing. The present review discusses the challenges and potentials of spinal cord stimulation for restoring respiratory function by overcoming some of the limitations of conventional respiratory functional electrical stimulation systems.

show abstract

Eingriffe am Zwerchfell

Grundmann¹

2006

Thoraxchirurgie

View full text Add to dashboard Cite

Diaphragm pacing

Cited by 25 publications

References 23 publications

State-of-the-Art Opinion Article on Ventilator-Induced Diaphragm Dysfunction: Update on Diagnosis, Clinical Course, and Future Treatment Options

State-of-the-Art Opinion Article on Ventilator-Induced Diaphragm Dysfunction: Update on Diagnosis, Clinical Course, and Future Treatment Options

Electrical Neuromodulation of the Respiratory System After Spinal Cord Injury

Eingriffe am Zwerchfell

Contact Info

Product

Resources

About