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Phrenic nerve stimulation prevents diaphragm atrophy in patients with respiratory failure on mechanical ventilation.
- Source :
-
BMC pulmonary medicine [BMC Pulm Med] 2021 Oct 08; Vol. 21 (1), pp. 314. Date of Electronic Publication: 2021 Oct 08. - Publication Year :
- 2021
-
Abstract
- Background: Diaphragm atrophy and dysfunction is a major problem among critically ill patients on mechanical ventilation. Ventilator-induced diaphragmatic dysfunction is thought to play a major role, resulting in a failure of weaning. Stimulation of the phrenic nerves and resulting diaphragm contraction could potentially prevent or treat this atrophy. The subject of this study is to determine the effectiveness of diaphragm stimulation in preventing atrophy by measuring changes in its thickness.<br />Methods: A total of 12 patients in the intervention group and 10 patients in the control group were enrolled. Diaphragm thickness was measured by ultrasound in both groups at the beginning of study enrollment (hour 0), after 24 hours, and at study completion (hour 48). The obtained data were then statistically analyzed and both groups were compared.<br />Results: The results showed that the baseline diaphragm thickness in the interventional group was (1.98 ± 0.52) mm and after 48 hours of phrenic nerve stimulation increased to (2.20 ± 0.45) mm (p=0.001). The baseline diaphragm thickness of (2.00 ± 0.33) mm decreased in the control group after 48 hours of mechanical ventilation to (1.72 ± 0.20) mm (p<0.001).<br />Conclusions: Our study demonstrates that induced contraction of the diaphragm by pacing the phrenic nerve not only reduces the rate of its atrophy during mechanical ventilation but also leads to an increase in its thickness - the main determinant of the muscle strength required for spontaneous ventilation and successful ventilator weaning.<br />Trial Registration: The study was registered with ClinicalTrials.gov (18/06/2018, NCT03559933, https://clinicaltrials.gov/ct2/show/NCT03559933 ).<br /> (© 2021. The Author(s).)
- Subjects :
- Aged
Critical Illness
Diaphragm diagnostic imaging
Electric Stimulation Therapy instrumentation
Female
Humans
Male
Middle Aged
Muscular Atrophy etiology
Muscular Atrophy physiopathology
Prospective Studies
Respiration, Artificial methods
Ultrasonography
Diaphragm physiopathology
Electric Stimulation Therapy methods
Phrenic Nerve physiology
Respiration, Artificial adverse effects
Respiratory Insufficiency therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2466
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC pulmonary medicine
- Publication Type :
- Academic Journal
- Accession number :
- 34625059
- Full Text :
- https://doi.org/10.1186/s12890-021-01677-2