Phrenic nerve conduction in infancy and early childhood

Imai, Tomihiro; Shizukawa, Hirohiko; Imaizumi, Hitoshi; Shichinohe, Yasuo; Sato, Morihito; Kikuchi, S.; Hachiro, Yoshikazu; Ito, Masayoshi; Kashiwagi, Motoi; Chiba, Susumu; Matsumoto, Hiroyuki

doi:10.1002/(sici)1097-4598(200006)23:6<915::aid-mus11>3.0.co;2-t

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…The phrenic nerve latencies recorded in the current study are similar to those reported previously [15,24,25]. Surface electrodes record activity from the costal component of the diaphragm while the oesophageal EMG records activity from the crural portion of the diaphragm [26].…”

Section: Discussionsupporting

confidence: 85%

Diaphragm electromyogram in infants with abdominal wall defects and congenital diaphragmatic hernia

et al. 2010

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Measurement of the diaphragm electromyogram (EMGdi) elicited by phrenic nerve stimulation could be useful to assess neonates suffering from respiratory distress due to diaphragm dysfunction, as observed in infants with abdominal wall defects (AWD) or congenital diaphragmatic hernia (CDH). The study aims were to assess the feasibility of recording EMGdi using a multipair oesophageal electrode catheter and examine whether diaphragm muscle and/or phrenic nerve function was compromised in AWD or CDH infants.Diaphragm compound muscle action potentials elicited by magnetic phrenic nerve stimulation were recorded from 18 infants with surgically repaired AWD (n513) or CDH (n55), median (range) gestational age 36.5 (34-40) weeks. Diaphragm strength was assessed as twitch transdiaphragmatic pressure (TwPdi).One AWD patient had prolonged phrenic nerve latency (PNL) bilaterally (left 9.31 ms, right 9.49 ms) and two CDH patients had prolonged PNL on the affected side (10.1 ms and 10.08 ms). There was no difference in left and right TwPdi in either group. PNL correlated significantly with TwPdi in CDH (r50.8; p50.009).Oesophageal EMG and magnetic stimulation of the phrenic nerves can be useful to assess phrenic nerve function in infants. Reduced phrenic nerve conduction accompanies the reduced diaphragm force production observed in infants with CDH.

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Section: Discussionsupporting

confidence: 85%

Diaphragm electromyogram in infants with abdominal wall defects and congenital diaphragmatic hernia

et al. 2010

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“…Phrenic nerve stimulation is simple and well tolerated, and it can be performed with surface stimulating and recording electrodes even in infants (24) and the elderly (20). The amplitude of the motor response depends on the number of excitable motor units in the diaphragm (37), but it is also affected by other factors, such as the respiratory cycle (24).…”

Section: Discussionmentioning

confidence: 99%

“…The amplitude of the motor response depends on the number of excitable motor units in the diaphragm (37), but it is also affected by other factors, such as the respiratory cycle (24). To minimize these effects, we stimulated the nerve at the end of the respiratory cycle.…”

Section: Discussionmentioning

confidence: 99%

“…The phrenic nerve was stimulated transcutaneously with 0.2-ms rectangular pulses using a bipolar electrode, and pressure was applied to the cathode inferomedially at the supraclavicular fossa. Each stimulus was timed to occur at the end of an expiration to minimize DCMAP amplitude variation (21)(22)(23)(24). Disposable surface disk electrodes (Viking, NEC, Tokyo, Japan) were placed over the xyphoid process (active) and the costal margin in the midclavicular line (reference) in bipolar derivation.…”

Section: Phrenic Nerve Conduction Studymentioning

confidence: 99%

“…Disposable surface disk electrodes (Viking, NEC, Tokyo, Japan) were placed over the xyphoid process (active) and the costal margin in the midclavicular line (reference) in bipolar derivation. The active and reference electrodes were connected to the differential amplitude so that an upward deflection of the waveform represents relative negativity (24). The ground electrode was placed over the upper part of the sternum.…”

Section: Phrenic Nerve Conduction Studymentioning

confidence: 99%

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Respiratory Insufficiency with Preserved Diaphragmatic Function in Amyotrophic Lateral Sclerosis

et al. 2014

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Objective We performed a longitudinal study to elucidate the correlation between respiratory insufficiency and respiratory biomarkers, including diaphragmatic compound muscle action potential (DCMAP), at the initiation of noninvasive ventilation (NIV) in patients with amyotrophic lateral sclerosis (ALS). Methods The patients were assessed at least every six months. Additional assessments were performed at the start of respiratory therapy when the patients met the criteria for the initiation of NIV. Each assessment consisted of a full neurological examination, a phrenic nerve conduction study, respiratory function tests, and nocturnal pulsed oximetry. Patients We enrolled 43 patients with either definite or probable ALS as defined by the revised El Escorial criteria. Results The patients were divided into two groups according to the timing of the initiation of respiratory therapy. Seventeen patients (group A) met the criteria for NIV initiation when their DCMAP remained normal. Twenty-six patients (group B) met the criteria when their DCMAP decreased below normal limits. Although respiratory function parameters were significantly worse in group B compared with group A at NIV initiation, more than 80% of the patients in both groups developed nocturnal desaturation during sleep. Conclusion DCMAP is not always a reliable indicator for determining the optimal timing for NIV initiation during the progression of respiratory insufficiency in ALS. Physicians should be aware of the risk of respiratory insufficiency during sleep in patients with ALS.

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Normal values for phrenic nerve latency in children

Russell¹,

Helps²,

Helms³

2001

Muscle and Nerve

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Data derived from detailed studies of normal phrenic nerve latency in a large group of children are presented. They highlight the major differences between the three previously published studies of normal children. Phrenic nerve latency shows a curvilinear relationship with age, averaging 6.0 ms at 0-6 months, falling to 4.8 ms between 1 and 2 years, then rising to 6.3 ms between 10 and 18 years of age. These data represent the largest published study on normal phrenic nerve latency in children.

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Phrenic nerve conduction in infancy and early childhood

Cited by 9 publications

References 13 publications

Diaphragm electromyogram in infants with abdominal wall defects and congenital diaphragmatic hernia

Diaphragm electromyogram in infants with abdominal wall defects and congenital diaphragmatic hernia

Respiratory Insufficiency with Preserved Diaphragmatic Function in Amyotrophic Lateral Sclerosis

Normal values for phrenic nerve latency in children

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