Inspiratory response and side-effects to rapid bilateral magnetic phrenic nerve stimulation using differently shaped coils: implications for stimulation-assisted mechanical ventilation

Respiratory Research

Research

Philipp A. Eichenberger¹  Patrick Schön¹  Kyle G. P. J. M. Boyle¹  Christina M. Spengler² 

[1] Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland;Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland;Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland;

关键词: Phrenic nerves;    Magnetic stimulation;    Diaphragm;    Mechanical ventilation;    Non-invasive ventilation;   

DOI  :  10.1186/s12931-022-02251-y

 received in 2022-07-19, accepted in 2022-11-14,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundRapid magnetic stimulation (RMS) of the phrenic nerves may serve to attenuate diaphragm atrophy during mechanical ventilation. With different coil shapes and stimulation location, inspiratory responses and side-effects may differ.This study aimed to compare the inspiratory and sensory responses of three different RMS-coils either used bilaterally on the neck or on the chest, and to determine if ventilation over 10 min can be achieved without muscle fatigue and coils overheating.MethodsHealthy participants underwent bilateral anterior 1-s RMS on the neck (RMSBAMPS) (N = 14) with three different pairs of magnetic coils (parabolic, D-shape, butterfly) at 15, 20, 25 and 30 Hz stimulator-frequency and 20% stimulator-output with + 10% increments. The D-shape coil with individual optimal stimulation settings was then used to ventilate participants (N = 11) for up to 10 min. Anterior RMS on the chest (RMSaMS) (N = 8) was conducted on an optional visit. Airflow was assessed via pneumotach and transdiaphragmatic pressure via oesophageal and gastric balloon catheters. Perception of air hunger, pain, discomfort and paresthesia were measured with a numerical scale.ResultsInspiration was induced via RMSBAMPS in 86% of participants with all coils and via RMSaMS in only one participant with the parabolic coil. All coils produced similar inspiratory and sensory responses during RMSBAMPS with the butterfly coil needing higher stimulator-output, which resulted in significantly larger discomfort ratings at maximal inspiratory responses. Ten of 11 participants achieved 10 min of ventilation without decreases in minute ventilation (15.7 ± 4.6 L/min).ConclusionsRMSBAMPS was more effective than RMSaMS, and could temporarily ventilate humans seemingly without development of muscular fatigue.Trial registration This study was registered on clinicaltrials.gov (NCT04176744).

【 授权许可】

CC BY   
© The Author(s) 2022

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