Evidence map›Paper›PMID 36717872›Full record

ArticleBiomedical engineering online2023

Feasibility of transesophageal phrenic nerve stimulation.

Elisa M Kaufmann, Sven Krause, Lukas Geisshuesler, Olivier Scheidegger, Andreas Haeberlin, Thomas Niederhauser

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Biomedical engineering online, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.8field-weighted citation impact, top 9% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 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

6 authors at 2 institutions in 1 country.

Elisa M KaufmannInstitute of Human Centered Engineering HuCE, Bern University of Applied Sciences, Biel, Switzerland.
Sven KrauseInstitute of Human Centered Engineering HuCE, Bern University of Applied Sciences, Biel, Switzerland.
Lukas GeisshueslerInstitute of Human Centered Engineering HuCE, Bern University of Applied Sciences, Biel, Switzerland.
Olivier ScheideggerDepartment Neurology, Bern University Hospital, University of Bern, Bern, Switzerland.
Andreas HaeberlinSitem Center for Translational Medicine and Biomedical Entrepreneurship, University of Bern, Bern, Switzerland.
Thomas NiederhauserInstitute of Human Centered Engineering HuCE, Bern University of Applied Sciences, Biel, Switzerland. thomas.niederhauser@bfh.ch.
University of Bern · CHBern University of Applied Sciences · CH

Funding

Berner Fachhochschule Research Grant for Doctoral StudentsSchweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung CRSK - 3190637/1
6 · The paper itself

Abstract

backgroundEvery year, more than 2.5 million critically ill patients in the ICU are dependent on mechanical ventilation. The positive pressure in the lungs generated by the ventilator keeps the diaphragm passive, which can lead to a loss of myofibers within a short time. To prevent ventilator-induced diaphragmatic dysfunction (VIDD), phrenic nerve stimulation may be used.

objectiveThe goal of this study is to show the feasibility of transesophageal phrenic nerve stimulation (TEPNS). We hypothesize that selective phrenic nerve stimulation can efficiently activate the diaphragm with reduced co-stimulations.

methodsAn in vitro study in saline solution combined with anatomical findings was performed to investigate relevant stimulation parameters such as inter-electrode spacing, range to target site, or omnidirectional vs. sectioned electrodes. Subsequently, dedicated esophageal electrodes were inserted into a pig and single stimulation pulses were delivered simultaneously with mechanical ventilation. Various stimulation sites and response parameters such as transdiaphragmatic pressure or airway flow were analyzed to establish an appropriate stimulation setting.

resultsPhrenic nerve stimulation with esophageal electrodes has been demonstrated. With a current amplitude of 40 mA, similar response figures of the diaphragm activation as compared to conventional stimulation with needle electrodes at 10mA were observed. Directed electrodes best aligned with the phrenic nerve resulted in up to 16.9 % higher amplitude at the target site in vitro and up to 6 cmH20 higher transdiaphragmatic pressure in vivo as compared to omnidirectional electrodes. The activation efficiency was more sensitive to the stimulation level inside the esophagus than to the inter-electrode spacing. Most effective and selective stimulation was achieved at the level of rib 1 using sectioned electrodes 40 mm apart.

conclusionDirected transesophageal phrenic nerve stimulation with single stimuli enabled diaphragm activation. In the future, this method might keep the diaphragm active during, and even support, artificial ventilation. Meanwhile, dedicated sectioned electrodes could be integrated into gastric feeding tubes.

Indexed as

DiaphragmPhrenic NerveAnimalsElectric StimulationElectrodesFeasibility StudiesRespiration, ArtificialSwineCritical careDiaphragm activationEsophageal catheterHospital mortalityIntensive care unitLung and diaphragm protectivePhrenic nerve stimulationTransesophageal stimulationVentilation induced diaphragmatic dysfunction

Identifiers

PMID36717872
PMCPMC9885573
OpenAlexW4318590639

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.