Noninvasive Electromagnetic Phrenic Nerve Stimulation in Critically Ill Patients

Panelli, Alessandro; Grimm, Aline M.; Krause, Sven; Verfuß, Michael A.; Ulm, Bernhard; Grunow, Julius J.; Bartels, Hermann G.; Carbon, Niklas M.; Niederhauser, Thomas; Weber-Carstens, Steffen; Brochard, Laurent; Schaller, Stefan J.

doi:10.1016/j.chest.2024.02.035

CHEST

2024

DOI: 10.1016/j.chest.2024.02.035

|View full text |Cite

Noninvasive Electromagnetic Phrenic Nerve Stimulation in Critically Ill Patients

Alessandro Panelli,

Aline M. Grimm,

Sven Krause

et al.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2024

Publication Types

Select...

Article2

Relationship

Self Cite0

Independent2

Authors

Journals

Cited by 2 publications

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Advances in achieving lung and diaphragm-protective ventilation

van den Berg,

Heunks,

Doorduin

2024

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of review Mechanical ventilation may have adverse effects on diaphragm and lung function. Lung- and diaphragm-protective ventilation is an approach that challenges the clinician to facilitate physiological respiratory efforts, while maintaining minimal lung stress and strain. Here, we discuss the latest advances in monitoring and interventions to achieve lung- and diaphragm protective ventilation. Recent findings Noninvasive ventilator maneuvers (P0.1, airway occlusion pressure, pressure-muscle index) can accurately detect low and excessive respiratory efforts and high lung stress. Additional monitoring techniques include esophageal manometry, ultrasound, electrical activity of the diaphragm, and electrical impedance tomography. Recent trials demonstrate that a systematic approach to titrating inspiratory support and sedation facilitates lung- and diaphragm protective ventilation. Titration of positive-end expiratory pressure and, if available, veno-venous extracorporeal membrane oxygenation sweep gas flow may further modulate neural respiratory drive and effort to facilitate lung- and diaphragm protective ventilation. Summary Achieving lung- and diaphragm-protective ventilation may require more than a single intervention; it demands a comprehensive understanding of the (neuro)physiology of breathing and mechanical ventilation, along with the application of a series of interventions under close monitoring. We suggest a bedside-approach to achieve lung- and diaphragm protective ventilation targets.

show abstract

Advances in achieving lung and diaphragm-protective ventilation

van den Berg,

Heunks,

Doorduin

2024

Current Opinion in Critical Care

View full text Add to dashboard Cite

show abstract

How to protect the diaphragm and the lung with diaphragm neurostimulation

Pellegrini,

Parfait,

Dres

2024

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of review In the current review, we aim to highlight the evolving evidence on using diaphragm neurostimulation to develop lung and diaphragm protective mechanical ventilation. Recent findings Positive-pressure ventilation (PPV) causes stress and strain to the lungs which leads to ventilator-induced lung injury (VILI). In addition, PPV is frequently associated with sedatives that induce excessive diaphragm unloading which contributes to ventilator-induced diaphragmatic dysfunction (VIDD). The nonvolitional diaphragmatic contractions entrained by diaphragm neurostimulation generate negative pressure ventilation, which may be a beneficial alternative or complement to PPV. Although well established as a permanent treatment of central apnea syndromes, temporary diaphragm neurostimulation rapidly evolves to prevent and treat VILI and VIDD. Experimental and small clinical studies report comprehensive data showing that diaphragm neurostimulation has the potential to mitigate VIDD and to decrease the stress and strain applied to the lungs. Summary Scientific interest in temporary diaphragm neurostimulation has dramatically evolved in the last few years. Despite a solid physiological rationale and promising preliminary findings confirming a beneficial effect on the diaphragm and lungs, more studies and further technological advances will be needed to establish optimal standardized settings and lead to clinical implementation and improved outcomes.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Noninvasive Electromagnetic Phrenic Nerve Stimulation in Critically Ill Patients

Cited by 2 publications

References 27 publications

Advances in achieving lung and diaphragm-protective ventilation

Advances in achieving lung and diaphragm-protective ventilation

How to protect the diaphragm and the lung with diaphragm neurostimulation

Contact Info

Product

Resources

About