ArticleBMC pulmonary medicine2021
Phrenic nerve stimulation prevents diaphragm atrophy in patients with respiratory failure on mechanical ventilation.
Article in BMC pulmonary medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Percutaneous Electrical Phrenic Nerve Stimulation (PEPNS) System Feasibility Study
A Randomized Controlled Study of the External Diaphragm Pacemaker Assisted Extubation in Premature Infants With Invasive Mechanical Ventilation
Electrical Phrenic Nerve Stimulation in Patients With Ventilator-induced Diaphragm Dysfunction: a Randomized Controlled Study
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Outcomes in critically ill patients after diaphragmatic stimulation on ventilator-induced diaphragmatic dysfunction: a systematic review.European journal of physical and rehabilitation medicine · 2023Pooled it
- Effects of external diaphragm pacing combined with conventional rehabilitation therapies in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.Therapeutic advances in respiratory diseasePooled it
- Effects of external diaphragmatic pacing with neurally adjusted ventilatory assist on diaphragm function in AECOPD patients.Scientific reports · 2025Trial
- Inspiratory response and side-effects to rapid bilateral magnetic phrenic nerve stimulation using differently shaped coils: implications for stimulation-assisted mechanical ventilation.Respiratory research · 2022Trial
- Neurological Complications in Intensive Care Units: From Delirium to Long-Term Cognitive Dysfunction-A Narrative Review.Journal of clinical medicine · 2026Review
- A preclinical rat model for bilateral phrenic nerve stimulation during mechanical ventilation.Animal models and experimental medicine · 2026Article
- Diaphragm stimulation in critically ill patients: what do we know, and what do we still need to learn?Einstein (Sao Paulo, Brazil) · 2026Article
- Article
- Intraoperative phrenic nerve stimulation to prevent diaphragm fiber weakness during thoracic surgery.PloS one · 2025Article
- Effects of external diaphragm pacing combined with repetitive peripheral magnetic stimulation of the phrenic nerve on respiratory function in stroke patients.Frontiers in medicine · 2025Article
- SARS‑CoV‑2 infection exacerbates diaphragmatic eventration: A case report.Biomedical reports · 2024Article
- Efficacy of ultrasonographic diaphragmatic parameters in distinguishing diaphragmatic dysfunction in cats.Journal of feline medicine and surgery · 2024Article
- Article
- Breath-by-breath comparison of a novel percutaneous phrenic nerve stimulation approach with mechanical ventilation in juvenile pigs: a pilot study.Scientific reports · 2024Article
- Perioperative Diaphragm Dysfunction.Journal of clinical medicine · 2024Review
- Phrenic nerve stimulation to prevent diaphragmatic dysfunction and ventilator-induced lung injury.Intensive care medicine experimental · 2023Review
- Phrenic Nerve Stimulation for Acute Respiratory Failure.Respiratory care · 2023Article
- First non-invasive magnetic phrenic nerve and diaphragm stimulation in anaesthetized patients: a proof-of-concept study.Intensive care medicine experimental · 2023Article
- Feasibility of transesophageal phrenic nerve stimulation.Biomedical engineering online · 2023Article
- Peripheral and respiratory muscle impairment during murine acute lung injury.Physiological reports · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiaphragm 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.
methodsA 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.
resultsThe 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).
conclusionsOur 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.
trial registrationThe study was registered with ClinicalTrials.gov (18/06/2018, NCT03559933, https://clinicaltrials.gov/ct2/show/NCT03559933 ).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.