Evidence map›Paper›PMID 35377472›Full record

ArticleArtificial organs2022

Non-invasive phrenic nerve stimulation to avoid ventilator-induced diaphragm dysfunction in critical care.

Conor Keogh, Francisco Saavedra, Sebastian Dubo, Pablo Aqueveque, Paulina Ortega, Britam Gomez, Enrique Germany, Daniela Pinto, Rodrigo Osorio, Francisco Pastene and 4 more

2 registry-linked trialsOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Artificial organs, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT05953649 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Effect of Early Extracorporeal Diaphragm Pacing （EDP） Combined With Tilt Table Verticalization （TTV) on Diaphragm Function in Critically Ill Patients With Mechanical Ventilation: a Randomized Controlled Trial.

TypeinterventionalSponsorSun Yat-Sen Memorial Hospital of Sun Yat-Sen UniversityRan2023 to 2024Enrolled90ConditionsEarly Mobilization, Critically Ill, Mechanical Ventilation, Diaphragm DysfunctionArmsExtracorporeal Diaphragm Pacing, Tilt Table Verticalization, Conventional Physiotherapy
NCT06049173 nacompletednot on this mapstarted 2023, after this paper: background citation

Evaluation of the Effect of Novel Recruitment Maneuver Therapy for Postoperative Pulmonary Atelectasis in the Patients With Cardiac Surgery

TypeinterventionalSponsorJilai XiaoRan2023 to 2024Enrolled77ConditionsPostoperative Pulmonary Atelectasis, Negative Pressure TherapyArmsNegative extra-abdominal pressure (NEXAP)-based lung recruitment maneuver, stepwise positive end-expiratory pressure (PEEP)-based lung recruitment maneuver
3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 2 countries.

Conor KeoghNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-6549-5460
Francisco SaavedraNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Sebastian DuboKinesiology Department, Universidad de Concepcion, Concepción, Chile.
Pablo AquevequeElectrical Engineering Department, Universidad de Concepcion, Concepción, Chile.
Paulina OrtegaKinesiology Department, Universidad de Concepcion, Concepción, Chile.
Britam GomezElectrical Engineering Department, Universidad de Concepcion, Concepción, Chile.
Enrique GermanyElectrical Engineering Department, Universidad de Concepcion, Concepción, Chile.
Daniela PintoElectrical Engineering Department, Universidad de Concepcion, Concepción, Chile.
Rodrigo OsorioElectrical Engineering Department, Universidad de Concepcion, Concepción, Chile.
Francisco PasteneElectrical Engineering Department, Universidad de Concepcion, Concepción, Chile.
Adrian PoultonNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Jonathan JarvisSchool of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
Brian AndrewsNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
James J FitzGeraldNuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
University of Concepción · CLUniversity of Oxford · GBLiverpool John Moores University · GB

Funding

Engineering and Physical Sciences Research CouncilNational Institute for Health ResearchUniversity of Oxford
6 · The paper itself

Abstract

backgroundDiaphragm muscle atrophy during mechanical ventilation begins within 24 h and progresses rapidly with significant clinical consequences. Electrical stimulation of the phrenic nerves using invasive electrodes has shown promise in maintaining diaphragm condition by inducing intermittent diaphragm muscle contraction. However, the widespread application of these methods may be limited by their risks as well as the technical and environmental requirements of placement and care. Non-invasive stimulation would offer a valuable alternative method to maintain diaphragm health while overcoming these limitations.

methodsWe applied non-invasive electrical stimulation to the phrenic nerve in the neck in healthy volunteers. Respiratory pressure and flow, diaphragm electromyography and mechanomyography, and ultrasound visualization were used to assess the diaphragmatic response to stimulation. The electrode positions and stimulation parameters were systematically varied in order to investigate the influence of these parameters on the ability to induce diaphragm contraction with non-invasive stimulation.

resultsWe demonstrate that non-invasive capture of the phrenic nerve is feasible using surface electrodes without the application of pressure, and characterize the stimulation parameters required to achieve therapeutic diaphragm contractions in healthy volunteers. We show that an optimal electrode position for phrenic nerve capture can be identified and that this position does not vary as head orientation is changed. The stimulation parameters required to produce a diaphragm response at this site are characterized and we show that burst stimulation above the activation threshold reliably produces diaphragm contractions sufficient to drive an inspired volume of over 600 ml, indicating the ability to produce significant diaphragmatic work using non-invasive stimulation.

conclusionThis opens the possibility of non-invasive systems, requiring minimal specialist skills to set up, for maintaining diaphragm function in the intensive care setting.

Indexed as

DiaphragmPhrenic NerveCritical CareElectric StimulationHumansRespiration, ArtificialVentilators, Mechanicalcritical careelectrical stimulationphrenic nerveventilator-induced diaphragm dysfunction

Identifiers

PMID35377472
PMCPMC9790411
OpenAlexW4223615200

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.