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Article Abstract
Introduction: Diaphragm neurostimulation is a muscle stimulation technique that, through electrodes placed directly on or at the vicinity of the phrenic nerves, induces diaphragm contractions independently of the patient's cooperation. Recently, the technical development of temporary diaphragm neurostimulation devices has paved the way for a new era in the management of critically ill patients.
Areas Covered: In this review, we describe the latest technical developments in diaphragm neurostimulation and its physiological effects. We searched MEDLINE of experimental and clinical studies in English language published from database inception until 31 October 2024. We also discuss the advances in terms of patients centered outcomes and the key areas for improvement. Lastly, we introduce possible future directions and the novel improvements in patient care.
Expert Opinion: The research on diaphragm neurostimulation promise as an emerging intervention which addresses common complications associated with mechanical ventilation. Large-scale clinical trials are necessary to validate diaphragm neurostimulation efficacy and safety in humans, establish treatment protocols, and determine cost-effectiveness, all of which are essential for diaphragm neurostimulation to be widely accepted in clinical practice.
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Diaphragm Neurostimulation: An Innovative Approach to Treat Diaphragm Weakness in Difficult to Wean Patients?
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University Health Network, Department of Medicine, Division of Respirology, Critical Care Program, Toronto, Ontario, Canada.
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Sorbonne Université, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Paris, France.
Introduction: Diaphragm neurostimulation is a muscle stimulation technique that, through electrodes placed directly on or at the vicinity of the phrenic nerves, induces diaphragm contractions independently of the patient's cooperation. Recently, the technical development of temporary diaphragm neurostimulation devices has paved the way for a new era in the management of critically ill patients.
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Department of Physiology.
Diaphragm inactivity during invasive mechanical ventilation may predispose the lung and diaphragm to injury and is associated with adverse clinical outcomes. Assess the feasibility of continuous on-demand diaphragm neurostimulation-assisted mechanical ventilation to maintain diaphragm activity in the absence of respiratory drive for at least 24 hours of mechanical ventilation. In a single-center phase 1 clinical trial, patients receiving invasive mechanical ventilation for acute hypoxemic respiratory failure or after thoracic surgery underwent transvenous diaphragm neurostimulation delivered in synchrony with mechanical ventilation.
View Article and Find Full Text PDFHow to protect the diaphragm and the lung with diaphragm neurostimulation.
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Sorbonne Université, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique.
Purpose Of Review: In the current review, we aim to highlight the evolving evidence on using diaphragm neurostimulation to develop lung and diaphragm protective mechanical ventilation.
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