Evaluation of electric phrenic nerve stimulation patterns for mechanical ventilation: a pilot study

Scientific Reports, vol. 13, pp. 11303

Abstract

Diaphragm atrophy is a common side effect of mechanical ventilation and results in prolonged weaning. Electric phrenic nerve stimulation presents a possibility to avoid diaphragm atrophy by keeping the diaphragm conditioned in sedated patients. There is a need of further investigation on how to set stimulation parameters to achieve sufficient ventilation. A prototype system is presented with a systematic evaluation for stimulation pattern adjustments. The main indicator for efficient stimulation was the tidal volume. The evaluation was performed in two pig models. As a major finding, the results for biphasic pulses were more consistent than for alternating pulses. The tidal volume increased for a range of pulse frequency and pulse width until reaching a plateau at 80-120 Hz and 0.15 ms. Furthermore, the generated tidal volume and the stimulation pulse frequency were significantly correlated (0.42-0.84, [Formula: see text]). The results show which stimulation parameter combinations generate the highest tidal volume. We established a guideline on how to set stimulation parameters. The guideline is helpful for future clinical applications of phrenic nerve stimulation.

Authors 9

1. Arnhold Lohse corresponding Aachen Medical Information Technology (MedIT) Faculty of Electrical Engineering and Information Technology

   RWTH Aachen University

   Affiliation as printed

   Medical Information Technology, Faculty of Electrical Engineering and Information Technology, RWTH Aachen University, 52072, Aachen, Germany. lohse@hia.rwth-aachen.de

   Medical Information Technology, Faculty of Electrical Engineering and Information Technology, RWTH Aachen University, 52072, Aachen, Germany

2. Philip von Platen Aachen Medical Information Technology (MedIT) Faculty of Electrical Engineering and Information Technology

   RWTH Aachen University

   Affiliation as printed

   Medical Information Technology, Faculty of Electrical Engineering and Information Technology, RWTH Aachen University, 52072, Aachen, Germany

3. Carl-Friedrich Benner Aachen Medical Information Technology (MedIT) Faculty of Electrical Engineering and Information Technology

   RWTH Aachen University

   Affiliation as printed

   Medical Information Technology, Faculty of Electrical Engineering and Information Technology, RWTH Aachen University, 52072, Aachen, Germany

4. Matthias Manfred Deininger Aachen Department of Intensive and Intermediate Care Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, 52072, Aachen, Germany

5. Teresa Seemann Aachen Department of Intensive and Intermediate Care Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, 52072, Aachen, Germany

6. Dmitrij Ziles Aachen Department of Intensive and Intermediate Care Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, 52072, Aachen, Germany

7. Thomas Breuer Aachen Department of Intensive and Intermediate Care Medical Faculty

   RWTH Aachen University

   Affiliation as printed

   Department of Intensive and Intermediate Care, Medical Faculty, RWTH Aachen University, 52072, Aachen, Germany

8. Steffen K. Leonhardt Aachen Medical Information Technology (MedIT) Faculty of Electrical Engineering and Information Technology

   RWTH Aachen University

   Affiliation as printed

   Medical Information Technology, Faculty of Electrical Engineering and Information Technology, RWTH Aachen University, 52072, Aachen, Germany

9. Marian Walter Aachen Medical Information Technology (MedIT) Faculty of Electrical Engineering and Information Technology

   RWTH Aachen University

   Affiliation as printed

   Medical Information Technology, Faculty of Electrical Engineering and Information Technology, RWTH Aachen University, 52072, Aachen, Germany