Panelli, Alessandro; Bartels, Hermann Georges; Krause, Sven; Verfuß, Michael André; Grimm, Aline Michèle; Carbon, Niklas Martin; Grunow, Julius J.; Stutzer, Diego; Niederhauser, Thomas; Brochard, Laurent; Weber-Carstens, Steffen; Schaller, Stefan J. (2023). First non-invasive magnetic phrenic nerve and diaphragm stimulation in anaesthetized patients: a proof-of-concept study Intensive Care Medicine Experimental, 11(20), pp. 1-13. SpringerOpen 10.1186/s40635-023-00506-6
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Background: Mechanical ventilation has side effects such as ventilator-induced diaphragm dysfunction, resulting in prolonged intensive care unit length of stays. Artificially evoked diaphragmatic muscle contraction may potentially maintain diaphragmatic muscle function and thereby ameliorate or counteract ventilator-induced diaphragm dysfunction. We hypothesized that bilateral non-invasive electromagnetic phrenic nerve stimulation (NEPNS) results in adequate diaphragm contractions and consecutively in effective tidal volumes. Results: This single-centre proof-of-concept study was performed in five patients who were 30 [IQR 21–33] years old, 60% (n = 3) females and undergoing elective surgery with general anaesthesia. Following anaesthesia and reversal of muscle relaxation, patients received bilateral NEPNS with different magnetic field intensities (10%, 20%, 30%, 40%); the stimulation was performed bilaterally with dual coils (connected to one standard clinical magnetic stimulator), specifically designed for bilateral non-invasive electromagnetic nerve stimulation. The stimulator with a maximal output of 2400 Volt, 160 Joule, pulse length 160 μs at 100% intensity was limited to 50% intensity, i.e. each single coil had a maximal output of 0.55 Tesla and 1200 Volt. There was a linear relationship between dosage (magnetic field intensity) and effect (tidal volume, primary endpoint, p < 0.001). Mean tidal volume was 0.00, 1.81 ± 0.99, 4.55 ± 2.23 and 7.43 ± 3.06 ml/kg ideal body weight applying 10%, 20%, 30% and 40% stimulation intensity, respectively. Mean time to find an initial adequate stimulation point was 89 (range 15–441) seconds. Conclusions: Bilateral non-invasive electromagnetic phrenic nerve stimulation generated a tidal volume of 3–6 ml/kg ideal body weight due to diaphragmatic contraction in lung-healthy anaesthetized patients. Further perspectives in critically ill patients should include assessment of clinical outcomes to confirm whether diaphragm contraction through non-invasive electromagnetic phrenic nerve stimulation potentially ameliorates or prevents diaphragm atrophy. Keywords: Respiration, Artificial, Mechanical ventilation weaning, Muscle weakness, Phrenic nerve, Magnetic field therapy
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
School of Engineering and Computer Science > Institute for Human Centered Engineering (HUCE) School of Engineering and Computer Science > Institute for Human Centered Engineering (HUCE) > HUCE / Laboratory for Microelectronics and Medical Devices School of Engineering and Computer Science BFH Centres and strategic thematic fields > BFH Energy Storage Research Centre |
Name: |
Panelli, Alessandro; Bartels, Hermann Georges; Krause, Sven; Verfuß, Michael André; Grimm, Aline Michèle; Carbon, Niklas Martin; Grunow, Julius J.; Stutzer, Diego; Niederhauser, Thomas  0000-0003-2633-0844; Brochard, Laurent; Weber-Carstens, Steffen and Schaller, Stefan J. |
Subjects: |
R Medicine > R Medicine (General) |
ISSN: |
2197-425X |
Publisher: |
SpringerOpen |
Language: |
English |
Submitter: |
Thomas Niederhauser |
Date Deposited: |
07 Jun 2023 08:59 |
Last Modified: |
07 Jun 2023 08:59 |
Publisher DOI: |
10.1186/s40635-023-00506-6 |
Related URLs: |
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ARBOR DOI: |
10.24451/arbor.19296 |
URI: |
https://arbor.bfh.ch/id/eprint/19296 |
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