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Noninvasive Electromagnetic Phrenic Nerve Stimulation in Critically Ill Patients: A Feasibility Study
Alessandro Panelli1, Aline M Grimm1, Sven Krause2
1Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany.
Bilateral transcutaneous noninvasive electromagnetic phrenic nerve stimulation (NEPNS) is feasible in critically ill patients, potentially preventing diaphragm atrophy during mechanical ventilation. Further research is needed to assess NEPNS ventilation effectiveness.
Area of Science:
- Critical Care Medicine
- Respiratory Physiology
- Medical Device Technology
Background:
- No clinical coils for phrenic nerve stimulation existed.
- Previous studies showed feasibility in healthy individuals.
- Diaphragm atrophy is a concern in ventilated patients.
Purpose of the Study:
- To assess the feasibility of bilateral transcutaneous noninvasive electromagnetic phrenic nerve stimulation (NEPNS) in critically ill ICU patients.
- To evaluate NEPNS's potential to prevent diaphragm atrophy.
Main Methods:
- A nonrandomized controlled feasibility study.
- Enrolled intubated patients expected to be ventilated for ≥72 hours.
- Intervention group received NEPNS twice daily; control received standard care.
Main Results:
- Feasible in ICU: median time to optimal stimulation 23 seconds.
- 87% of scheduled NEPNS sessions completed; 92% with catch-up.
- Reduced diaphragm thickness decrease (P=.034) until day 10.
Conclusions:
- Bilateral transcutaneous NEPNS is feasible in the ICU.
- NEPNS may prevent diaphragm atrophy during mechanical ventilation.
- Further studies required to confirm NEPNS ventilation effectiveness.
