Healthy Clinical Trial
Official title:
Optimization of Non-invasive Diaphragm Activation Using Magnetic Phrenic Nerve Stimulation
The use of mechanical ventilation (MV) to replace spontaneous breathing has been associated
with respiratory muscle dysfunction and lung injury from positive pressure. While using MV in
an intensive care unit setting, the diaphragm is unloaded, potentially resulting in early
development of diaphragmatic atrophy in as early as 18 hours of complete diaphragm
inactivity. These changes in muscle properties result in a decrease in the force generating
capability of the muscle, ultimately resulting in difficulty to restore spontaneous breathing
and a subsequent prolonged weaning process or failure. A prolonged weaning period is
associated with longer duration of MV, which may result in a cascade of further diaphragm
dysfunction, weakness, and injury.
Stimulation of the phrenic nerves to produce diaphragm contraction and activity is a possible
mechanism to reduce MV related diaphragm dysfunction. Two promising studies have shown the
potential of repetitive phrenic nerve stimulation on inducing diaphragm activity in human
subjects with trains of pulses via both cervical and bilateral phrenic nerve stimulation.
However, neither study provided optimal stimulation settings. As such, the primary purpose of
this study is to investigate the optimal settings for noninvasive phrenic nerve stimulation
to induce diaphragm contraction.
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