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Diaphragm pacing

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https://www.readbyqxmd.com/read/29319015/a-practical-technique-in-laparoscopic-diaphragm-pacing-surgery-retrospective-analyse-of-43-patients
#1
Volkan Karacam, Aydin Sanli, Kemal Can Tertemiz, Ilknur Ulugun
INTRODUCTION: Diaphragm pacing stimulation (DPS) is a treatment method used in respiratory failure occurs in diseases such as high-level cervical spinal cord injury, central hypoventilation syndrome and amyotrophic lateral sclerosis. MATERIALS AND METHODS: A total of 43 patients, who had undergone DPS implantation surgery were evaluated retrospectively. The patients were divided into two groups according to the surgical technique (Group 1: classical surgical technic and Group 2: modified surgical technic) applied...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29195690/completed-fda-feasibility-trial-of-surgically-placed-temporary-diaphragm-pacing-electrodes-a-promising-option-to-prevent-and-treat-respiratory-failure
#2
Raymond P Onders, Alan Markowitz, Vanessa P Ho, Jeff Hardacre, Yuri Novitsky, Christopher Towe, MaryJo Elmo, Cindy Kaplan, Robert Schilz
BACKGROUND: Etiologies contributing to failure to wean from mechanical ventilation (MV) are multiple, resulting in morbid and costly outcomes. Diaphragm pacing (DP) is used in spinal cord injury to replace MV. Temporary DP could be utilized in acute respiratory failure to reduce MV. METHODS: A prospective FDA feasibility trial evaluated temporary DP electrodes implanted in each hemi-diaphragm during a subject's primary procedure. Objectives included: ability to provide ventilation, stability analysis with diaphragm electromyography, and adverse event monitoring...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29181382/reinnervation-of-the-diaphragm-by-the-inferior-laryngeal-nerve-to-the-phrenic-nerve-in-ventilator-dependent-tetraplegic-patients-with-c3-5-damage
#3
Eric Verin, Capucine Morelot-Panzini, Jesus Gonzalez-Bermejo, Benoit Veber, Brigitte Perrouin Verbe, Brigitte Soudrie, Anne Marie Leroi, Jean Paul Marie, Thomas Similowski
The aim of this study was to evaluate the feasibility of unilateral diaphragmatic reinnervation in humans by the inferior laryngeal nerve. This pilot study included chronically ventilated tetraplegic patients with destruction of phrenic nerve motoneurons. Five patients were included. They all had a high level of tetraplegia, with phrenic nerve motor neuron destruction. They were highly dependent on ventilation, without any possibility of weaning. They did not have other chronic pathologies, especially laryngeal disease...
October 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28990225/feasibility-of-diaphragm-pacing-in-patients-after-bilateral-lung-transplantation
#4
Dries Testelmans, Philippe Nafteux, Sophie Van Cromphaut, Bart Vrijsen, Robin Vos, Paul De Leyn, Herbert Decaluwé, Dirk Van Raemdonck, Geert M Verleden, Bertien Buyse
Recent animal studies and intra-operative studies in humans suggested that phrenic nerve stimulation could attenuate ventilator-induced diaphragm dysfunction. The purpose of the present study is to examine the safety and feasibility of diaphragm pacing during the weaning process after bilateral lung transplantation. Four patients, suffering from chronic pulmonary disease, were included, and diaphragm pacing was evaluated after lung transplantation. Implantation of electrodes at the end of the lung transplant procedure was possible in three of the four patients...
October 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28916788/a-v0-core-neuronal-circuit-for-inspiration
#5
Jinjin Wu, Paolo Capelli, Julien Bouvier, Martyn Goulding, Silvia Arber, Gilles Fortin
Breathing in mammals relies on permanent rhythmic and bilaterally synchronized contractions of inspiratory pump muscles. These motor drives emerge from interactions between critical sets of brainstem neurons whose origins and synaptic ordered organization remain obscure. Here, we show, using a virus-based transsynaptic tracing strategy from the diaphragm muscle in the mouse, that the principal inspiratory premotor neurons share V0 identity with, and are connected by, neurons of the preBötzinger complex that paces inspiration...
September 15, 2017: Nature Communications
https://www.readbyqxmd.com/read/28765767/simple-and-effective-solution-for-diaphragm-pacing-by-that-uses-the-transvenous-femoral-approach-in-a-patient-treated-with-cardiac-resynchronization-defibrillator-therapy-the-wrapping-method
#6
Ahmet Taha Alper, Mert İlker Hayıroğlu, Ahmet İlker Tekkeşin, Ceyhan Türkkan
The use of cardiac resynchronization therapy (CRT) has become widespread in patients with heart failure who meet the criteria for implantation. Coronary sinus lead positioning is important to provide the intended biventricular stimulation. Diaphragm pacing is a lead-related complication which occurs secondary to phrenic nerve stimulation. We present the case of a 58-year-old male patient who had diaphragm pacing after CRT with defibrillator implantation. The complication was resolved by using the transvenous femoral approach with the wrapping method...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28614935/-clinical-observation-of-external-diaphragm-pacing-in-patients-with-pneumoconiosis-complicated-with-chronic-obstructive-pulmonary-disease-in-stable-stage
#7
P Jiang, X C Liu, L L Ma
No abstract text is available yet for this article.
April 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/28570440/successful-reinnervation-of-the-diaphragm-after-intercostal-to-phrenic-nerve-neurotization-in-patients-with-high-spinal-cord-injury
#8
Kulvir S Nandra, Martin Harari, Thea P Price, Patrick J Greaney, Michael S Weinstein
OBJECTIVE: Our objective in this study was to extend diaphragmatic pacing therapy to include paraplegic patients with high cervical spinal cord injuries between C3 and C5. INTRODUCTION: Diaphragmatic pacing has been used in patients experiencing ventilator-dependent respiratory failure due to spinal cord injury as a means to reduce or eliminate the need for mechanical ventilation. However, this technique relies on intact phrenic nerve function. Recently, phrenic nerve reconstruction with intercostal nerve grafting has expanded the indications for diaphragmatic pacing...
August 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28441238/diaphragm-activation-in-ventilated-patients-using-a-novel-transvenous-phrenic-nerve-pacing-catheter
#9
Steven Reynolds, Adrian Ebner, Tracy Meffen, Viral Thakkar, Matt Gani, Kaity Taylor, Linda Clark, Gautam Sadarangani, Ramasamy Meyyappan, Rodrigo Sandoval, Elizabeth Rohrs, Joaquín A Hoffer
OBJECTIVES: Over 30% of critically ill patients on positive-pressure mechanical ventilation have difficulty weaning from the ventilator, many of whom acquire ventilator-induced diaphragm dysfunction. Temporary transvenous phrenic nerve pacing using a novel electrode-bearing catheter may provide a means to prevent diaphragm atrophy, to strengthen an atrophied diaphragm, and mitigate the harms of mechanical ventilation. We tested the initial safety, feasibility, and impact on ventilation of this novel approach...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28298842/preoperative-parameters-and-their-prognostic-value-in-amyotrophic-lateral-sclerosis-patients-undergoing-implantation-of-a-diaphragm-pacing-stimulation-system
#10
Aydın Şanlı, Ihsan Şükrü Şengün, Volkan Karaçam, Aylin Özgen Alpaydın, Kemal Can Tertemiz, Sevgi Özalevli, Bahar Ağaoğlu Şanlı, Alper Kaya, Nezih Özdemir
INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease with devastating and fatal respiratory complications. Diaphragm pacing stimulation (DPS) is a treatment option in diaphragm insufficient ALS patients. Ventilatory insufficiency depending on diaphragmatic failure is treated by the present study aimed to investigate prognostic value of preoperative clinical and functional characteristics of ALS patients undergoing implantation of a DPS system and to determine appropriate indications for the DPS system...
January 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28054365/mapping-for-acute-transvenous-phrenic-nerve-stimulation-study-maps-study
#11
MULTICENTER STUDY
Lukas R C Dekker, Bart Gerritse, Avram Scheiner, Lilian Kornet
BACKGROUND: Central sleep apnea syndrome, correlated with the occurrence of heart failure, is characterized by periods of insufficient ventilation during sleep. This acute study in 15 patients aims to map the venous system and determine if diaphragmatic movement can be achieved by phrenic nerve stimulation at various locations within the venous system. METHODS: Subjects underwent a scheduled catheter ablation procedure. During the procedural waiting time, one multielectrode electrophysiology catheter was subsequently placed at the superior and inferior vena cava and the junctions of the left jugular and left brachiocephalic vein and right jugular and right brachiocephalic vein, for phrenic nerve stimulation (1-2 seconds ON/2-3 seconds OFF, 40 Hz, pulse width 210 μs)...
March 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27904119/an-autopsy-case-of-amyotrophic-lateral-sclerosis-with-diaphragm-pacing
#12
Hisashi Ito, Tetsumasa Kamei, Sanae Odake, Masayuki Nakano, Riki Okeda, Shunsaku Kohriki, Jun Kawachi, Raymond P Onders, Fumihito Yoshii
Respiratory insufficiency is a critical problem in amyotrophic lateral sclerosis (ALS) patients. We herein present the case of an autopsied patient with sporadic ALS who underwent diaphragm pacing (DP). The pathology showed several localized adhesions with a markedly atrophied diaphragm. A marked loss of motor neurons with Bunina bodies and phosphorylated TDP-43 positive inclusions was found in the spinal cord and primary motor cortex. Mild hyalinization and a few multinucleated giant cells were present around the electrode tracks in the diaphragm...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27836647/corrective-effect-of-diaphragm-pacing-on-the-decrease-in-cardiac-output-induced-by-positive-pressure-mechanical-ventilation-in-anesthetized-sheep
#13
Hicham Masmoudi, Romain Persichini, Jérôme Cecchini, Julie Delemazure, Martin Dres, Julien Mayaux, Alexandre Demoule, Jalal Assouad, Thomas Similowski
Positive pressure ventilation (PPV) is a fundamental life support measure, but it decreases cardiac output (CO). Diaphragmatic contractions produce negative intrathoracic and positive abdominal pressures, promoting splanchnic venous return. We hypothesized that: 1) diaphragm pacing alone could produce adequate ventilation without decreasing CO; 2) diaphragm pacing on top of PPV could improve CO. Of 11 anesthetized and mechanically ventilated ewes (39.6±5.9kg), 3 were discarded from analysis because of hemodynamic instability during the experiment, and 8 retained for analysis...
February 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27759115/kinetics-of-ventilation-induced-changes-in-diaphragmatic-metabolism-by-bilateral-phrenic-pacing-in-a-piglet-model
#14
Thomas Breuer, Nima Hatam, Benjamin Grabiger, Gernot Marx, Bradley J Behnke, Joachim Weis, Ruedger Kopp, Ghislaine Gayan-Ramirez, Norbert Zoremba, Christian S Bruells
Perioperative necessity of deep sedation is inevitably associated with diaphragmatic inactivation. This study investigated 1) the feasibility of a new phrenic nerve stimulation method allowing early diaphragmatic activation even in deep sedation and, 2) metabolic changes within the diaphragm during mechanical ventilation compared to artificial activity. 12 piglets were separated into 2 groups. One group was mechanically ventilated for 12 hrs (CMV) and in the second group both phrenic nerves were stimulated via pacer wires inserted near the phrenic nerves to mimic spontaneous breathing (STIM)...
October 19, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27751553/early-diaphragm-pacing-in-patients-with-amyotrophic-lateral-sclerosis-respistimals-a-randomised-controlled-triple-blind-trial
#15
RANDOMIZED CONTROLLED TRIAL
Jésus Gonzalez-Bermejo, Capucine Morélot-Panzini, Marie-Laure Tanguy, Vincent Meininger, Pierre-François Pradat, Timothée Lenglet, Gaëlle Bruneteau, Nadine Le Forestier, Philippe Couratier, Nathalie Guy, Claude Desnuelle, Hélène Prigent, Christophe Perrin, Valérie Attali, Catherine Fargeot, Marie-Cécile Nierat, Catherine Royer, Fabrice Ménégaux, François Salachas, Thomas Similowski
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder associated with respiratory muscle weakness and respiratory failure. Non-invasive ventilation alleviates respiratory symptoms and prolongs life, but is a palliative intervention. Slowing the deterioration of diaphragm function before respiratory failure would be desirable. We aimed to assess whether early diaphragm pacing could slow down diaphragm deterioration and would therefore delay the need for non-invasive ventilation...
November 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27576008/mild-aerobic-exercise-training-hardly-affects-the-diaphragm-of-mdx-mice
#16
Giuseppe Morici, Monica Frinchi, Alessandro Pitruzzella, Valentina Di Liberto, Rosario Barone, Andrea Pace, Valentina Di Felice, Natale Belluardo, Francesco Cappello, Giuseppa Mudò, Maria R Bonsignore
In the mdx mice model of Duchenne Muscular Dystrophy (DMD), mild endurance exercise training positively affected limb skeletal muscles, whereas few and controversial data exist on the effects of training on the diaphragm. The diaphragm was examined in mdx (C57BL/10ScSn-Dmdmdx) and wild-type (WT, C57BL/10ScSc) mice under sedentary conditions (mdx-SD, WT-SD) and during mild exercise training (mdx-EX, WT-EX). At baseline, and after 30 and 45 days (training: 5 d/wk for 6 weeks), diaphragm muscle morphology and Cx39 protein were assessed...
August 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27558755/factors-influencing-diaphragmatic-compound-motor-action-potentials-during-cryoballoon-ablation-for-atrial-fibrillation
#17
Parikshit S Sharma, Santosh K Padala, J Jenkins Thompson, Sampath Gunda, Jayanthi N Koneru, Kenneth A Ellenbogen
INTRODUCTION: The diaphragmatic compound motor action potentials (CMAPs) have been used to predict and prevent phrenic nerve injury (PNI) during cryoballoon ablation of right pulmonary veins. We sought to assess factors that influence the amplitude of the surface CMAP recordings. METHODS AND RESULTS: We analyzed CMAPs from consecutive patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation. CMAP recordings were obtained using electrocardiography electrodes positioned in the "modified lead I" method while stimulating the right PN, until loss of capture (ascertained by palpation and fluoroscopy of the right hemi-diaphragm)...
December 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27500981/mitigation-of-ventilator-induced-diaphragm-atrophy-by-transvenous-phrenic-nerve-stimulation
#18
Steven C Reynolds, Ramasamy Meyyappan, Viral Thakkar, Bao D Tran, Marc-André Nolette, Gautam Sadarangani, Rodrigo A Sandoval, Laura Bruulsema, Brett Hannigan, Jason W Li, Elizabeth Rohrs, Jason Zurba, Joaquín Andrés Hoffer
RATIONALE: Ventilator-induced diaphragm dysfunction is a significant contributor to weaning difficulty in ventilated critically ill patients. It has been hypothesized that electrically pacing the diaphragm during mechanical ventilation could reduce diaphragm dysfunction. OBJECTIVES: We tested a novel, central line catheter-based, transvenous phrenic nerve pacing therapy for protecting the diaphragm in sedated and ventilated pigs. METHODS: Eighteen Yorkshire pigs were studied...
February 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27353839/dipals-diaphragm-pacing-in-patients-with-amyotrophic-lateral-sclerosis-a-randomised-controlled-trial
#19
Christopher J McDermott, Mike J Bradburn, Chin Maguire, Cindy L Cooper, Wendy O Baird, Susan K Baxter, Judith Cohen, Hannah Cantrill, Simon Dixon, Roger Ackroyd, Simon Baudouin, Andrew Bentley, Richard Berrisford, Stephen Bianchi, Stephen C Bourke, Roy Darlison, John Ealing, Mark Elliott, Patrick Fitzgerald, Simon Galloway, Hisham Hamdalla, C Oliver Hanemann, Philip Hughes, Ibrahim Imam, Dayalan Karat, Roger Leek, Nick Maynard, Richard W Orrell, Abeezar Sarela, John Stradling, Kevin Talbot, Lyn Taylor, Martin Turner, Anita K Simonds, Tim Williams, Wisia Wedzicha, Carolyn Young, Pamela J Shaw
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease resulting in death, usually from respiratory failure, within 2-3 years of symptom onset. Non-invasive ventilation (NIV) is a treatment that when given to patients in respiratory failure leads to improved survival and quality of life. Diaphragm pacing (DP), using the NeuRx/4(®) diaphragm pacing system (DPS)™ (Synapse Biomedical, Oberlin, OH, USA), is a new technique that may offer additional or alternative benefits to patients with ALS who are in respiratory failure...
June 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27195135/diaphragm-pacing-the-state-of-the-art
#20
REVIEW
Francoise Le Pimpec-Barthes, Antoine Legras, Alex Arame, Ciprian Pricopi, Jean-Claude Boucherie, Alain Badia, Capucine Morelot Panzini
Diaphragm pacing (DP) is an orphan surgical procedure that may be proposed in strictly selected ventilator-dependent patients to get an active diaphragm contraction. The goal is to wean from mechanical ventilation (MV) and restore permanent efficient breathing. The two validated indications, despite the lack of randomised control trials, concern patients with high-level spinal cord injuries (SCI) and central hypoventilation syndromes (CHS). To date, two different techniques exist. The first, intrathoracic diaphragm pacing (IT-DP), based on a radiofrequency method, in which the electrodes are directly placed around the phrenic nerve...
April 2016: Journal of Thoracic Disease
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