Temporary Transvenous Phrenic-Nerve-Stimulated Diaphragm Neurostimulation During Mechanical Ventilation Preserves Homogeneity in Non-Injured Lungs

Rohrs, Elizabeth; Ornowska, Marlena; Bassi, T.; Fernandez, K.; Nicholas, Michelle; Reynolds, Steven

doi:10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a4120

Cited by 3 publications

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“…Consequently, reduced inflammation or a change in the vagal signal during MV could mitigate cellular apoptosis in the hippocampus. Some of the results of these studies have been previously reported in the form of abstracts ( 6 , 14 , 15 ).…”

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confidence: 94%

“…13,14 In a preclinical study, our group has shown that TTDN also reduced atelectasis and preserved lung homogeneity during MV. 15,16 We hypothesize that by preserving lung homogeneity during MV, TTDN either could dampen the inflammatory process associated with MV, or could change the pulmonary afferent signal during MV. Consequently, reduced inflammation or a change in the vagal signal during MV could mitigate cellular apoptosis in the hippocampus.…”

Section: Introduction: (416 Out Of 450 Words)mentioning

confidence: 99%

“…Some of the results of these studies have been previously reported in the form of abstracts. 6,14,15 Methodology: (see online data supplement) 616 words Animals:…”

Section: Introduction: (416 Out Of 450 Words)mentioning

confidence: 99%

“…Temporary transvenous diaphragm neurostimulation (TTDN) is a hybrid ventilation strategy that combines bilateral phrenic nerve stimulation in synchrony with MV, aiming initially to rescue the diaphragm from atrophy secondary to MV ( 13 , 14 ). In a preclinical study, our group has shown that TTDN also reduced atelectasis and preserved lung homogeneity during MV ( 15 , 16 ). We hypothesize that by preserving lung homogeneity during MV, TTDN could either dampen the inflammatory process associated with MV or change the pulmonary afferent signal during MV.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Transvenous Diaphragm Neurostimulation Mitigates Ventilation-associated Brain Injury

Bassi

Rohrs

Fernandez

et al. 2021

Am J Respir Crit Care Med

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TGB and DE were responsible for hypothesis generation. TGB, SCR and ECR were responsible for the conception of this study. TGB, SCR, ECR and MG contributed to study design and data interpretation. TGB, ECR, SCR and MG were responsible for writing the article. TGB, ECR, KCF, MO, SCR and MN performed data acquisition. TGB, ECR, MO, SCR and MN conducted data analysis. All authors have agreed with the final version of the manuscript before submission.

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mentioning

confidence: 94%

Section: Introduction: (416 Out Of 450 Words)mentioning

confidence: 99%

“…Some of the results of these studies have been previously reported in the form of abstracts. 6,14,15 Methodology: (see online data supplement) 616 words Animals:…”

Section: Introduction: (416 Out Of 450 Words)mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Transvenous Diaphragm Neurostimulation Mitigates Ventilation-associated Brain Injury

Bassi

Rohrs

Fernandez

et al. 2021

Am J Respir Crit Care Med

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“…Phrenic nerve stimulation (PNS) may be uniquely situated to achieve both lung and diaphragm-protective ventilation. Previous animal studies have demonstrated that PNS during mechanical ventilation can mitigate VIDD [49][50][51]. A study by Reynolds et al [52] examined the use of temporary transvenous PNS, the LIVE catheter from Lungpacer Medical Inc (Vancouver, British Columbia, Canada) in a porcine model.…”

Section: The Potential Role Of Phrenic Nerve Stimulation For Lung And...mentioning

confidence: 99%

Diaphragm function in acute respiratory failure and the potential role of phrenic nerve stimulation

Reardon

Wong

Fitzpatrick

et al. 2021

Current Opinion in Critical Care

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Purpose of reviewThe aim of this review was to describe the risk factors for developing diaphragm dysfunction, discuss the monitoring techniques for diaphragm activity and function, and introduce potential strategies to incorporate diaphragm protection into conventional lung-protective mechanical ventilation strategies. Recent findingsIt is increasingly apparent that an approach that addresses diaphragm-protective ventilations goals is needed to optimize ventilator management and improve patient outcomes. Ventilator-induced diaphragm dysfunction (VIDD) is common and is associated with increased ICU length of stay, prolonged weaning and increased mortality. Over-assistance, under-assistance and patient-ventilator dyssynchrony may have important downstream clinical consequences related to VIDD. Numerous monitoring techniques are available to assess diaphragm function, including respiratory system pressures, oesophageal manometry, diaphragm ultrasound and electromyography. Novel techniques including phrenic nerve stimulation may facilitate the achievement of lung and diaphragm-protective goals for mechanical ventilation.

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Restoring brain connectivity by phrenic nerve stimulation in sedated and mechanically ventilated patients

Bassi,

Rohrs E,

Parfait

et al. 2024

Commun Med

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Background In critically ill patients, deep sedation and mechanical ventilation suppress the brain-diaphragm-lung axis and are associated with cognitive issues in survivors. Methods This exploratory crossover design study investigates whether phrenic nerve stimulation can enhance brain activity and connectivity in six deeply sedated, mechanically ventilated patients with acute respiratory distress syndrome. Results Our findings indicate that adding phrenic stimulation on top of invasive mechanical ventilation in deeply sedated, critically ill, moderate acute respiratory distress syndrome patients increases cortical activity, connectivity, and synchronization in the frontal-temporal-parietal cortices. Conclusions Adding phrenic stimulation on top of invasive mechanical ventilation in deeply sedated, critically ill, moderate acute respiratory distress syndrome patients increases cortical activity, connectivity, and synchronization. The observed changes resemble those during diaphragmatic breathing in awake humans. These results suggest that phrenic nerve stimulation has the potential to restore the brain-diaphragm-lung crosstalk when it has been shut down or impaired by mechanical ventilation and sedation. Further research should evaluate the clinical significance of these results.

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Temporary Transvenous Phrenic-Nerve-Stimulated Diaphragm Neurostimulation During Mechanical Ventilation Preserves Homogeneity in Non-Injured Lungs

Cited by 3 publications

References 0 publications

Transvenous Diaphragm Neurostimulation Mitigates Ventilation-associated Brain Injury

Transvenous Diaphragm Neurostimulation Mitigates Ventilation-associated Brain Injury

Diaphragm function in acute respiratory failure and the potential role of phrenic nerve stimulation

Restoring brain connectivity by phrenic nerve stimulation in sedated and mechanically ventilated patients

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