Phrenic nerve stimulation in an ovine model with temporary removable pacing leads.

Temporary neurostimulation ovine model phrenic nerve

Journal

Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916

Informations de publication

Date de publication:
Aug 2022
Historique:
received: 18 12 2021
accepted: 08 04 2022
entrez: 8 9 2022
pubmed: 9 9 2022
medline: 9 9 2022
Statut: ppublish

Résumé

The objective of this study was to assess the feasibility and safety of a novel, removable, surgically implanted, temporary neurostimulation approach involving the distal portion of the phrenic nerve. Temporary phrenic nerve pacing electrodes were implanted surgically using an ovine model (4 animals). The primary endpoint was the ability to successfully match the animal's minute-ventilation upon implantation of both phrenic nerve pacers on day 1. Secondary endpoints were successful phrenic neurostimulation by both electrodes 15 and 30 days after initial implantation. We also assessed safe removal of the electrodes at 15 and 30 days after implementation. In 3 of 4 animals, electrodes were successfully implanted in both right and left phrenic nerves. On day 1, median ventilation-minute induced by neurostimulation was not significantly different from baseline ventilation-minute [4.9 L·min Efficient temporary neurostimulation through the distal portion of the phrenic nerve was possible at baseline. The main complication was the displacement of electrodes on the right phrenic nerve on two occasions, which was due to the anatomy of the ovine model. It compromised diaphragm pacing on day 15 and day 30. The electrodes could be safely removed percutaneously without damage to the phrenic nerves.

Sections du résumé

Background UNASSIGNED
The objective of this study was to assess the feasibility and safety of a novel, removable, surgically implanted, temporary neurostimulation approach involving the distal portion of the phrenic nerve.
Methods UNASSIGNED
Temporary phrenic nerve pacing electrodes were implanted surgically using an ovine model (4 animals). The primary endpoint was the ability to successfully match the animal's minute-ventilation upon implantation of both phrenic nerve pacers on day 1. Secondary endpoints were successful phrenic neurostimulation by both electrodes 15 and 30 days after initial implantation. We also assessed safe removal of the electrodes at 15 and 30 days after implementation.
Results UNASSIGNED
In 3 of 4 animals, electrodes were successfully implanted in both right and left phrenic nerves. On day 1, median ventilation-minute induced by neurostimulation was not significantly different from baseline ventilation-minute [4.9 L·min
Conclusions UNASSIGNED
Efficient temporary neurostimulation through the distal portion of the phrenic nerve was possible at baseline. The main complication was the displacement of electrodes on the right phrenic nerve on two occasions, which was due to the anatomy of the ovine model. It compromised diaphragm pacing on day 15 and day 30. The electrodes could be safely removed percutaneously without damage to the phrenic nerves.

Identifiants

pubmed: 36071760
doi: 10.21037/jtd-21-1944
pii: jtd-14-08-2748
pmc: PMC9442545
doi:

Types de publication

Journal Article

Langues

eng

Pagination

2748-2756

Informations de copyright

2022 Journal of Thoracic Disease. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-21-1944/coif). All authors report funding of the experimental procedures by Atrotech (Tampere, Finland). The authors have no other conflicts of interest to declare.

Références

Am J Respir Crit Care Med. 2020 Oct 1;202(7):950-961
pubmed: 32516052
J Thorac Cardiovasc Surg. 2011 Aug;142(2):378-83
pubmed: 21620417
Am J Respir Crit Care Med. 2014 Oct 1;190(7):837-9
pubmed: 25271750
N Engl J Med. 1984 May 3;310(18):1150-5
pubmed: 6608692
Am J Respir Crit Care Med. 1994 Jun;149(6):1539-44
pubmed: 8004310
Anesthesiology. 2019 Aug;131(2):266-278
pubmed: 31166236
Eur Respir J. 2015 Jun;45(6):1751-4
pubmed: 25900376
J Appl Physiol (1985). 2021 Jun 1;130(6):1736-1742
pubmed: 33830811
Crit Care Med. 2020 May;48(5):e362-e370
pubmed: 32191413
Ann Anat. 2022 Jan;239:151835
pubmed: 34562604
Eur J Cardiothorac Surg. 2012 Aug;42(2):333-9
pubmed: 22402455
Am J Respir Crit Care Med. 2017 Feb 1;195(3):339-348
pubmed: 27500981
N Engl J Med. 2008 Mar 27;358(13):1327-35
pubmed: 18367735
Ann Surg. 2011 Dec;254(6):1044-9
pubmed: 21975323
Am J Respir Crit Care Med. 2017 Mar 15;195(6):772-783
pubmed: 27626706
J Am Assoc Lab Anim Sci. 2015 Mar;54(2):120-32
pubmed: 25836957
Pacing Clin Electrophysiol. 2013 Jun;36(6):714-8
pubmed: 23305494
Clin Transplant. 2017 Dec;31(12):
pubmed: 28990225
J Cardiothorac Vasc Anesth. 2020 Dec;34(12):3336-3344
pubmed: 32653270
J Transl Med. 2016 Oct 26;14(1):305
pubmed: 27784315
Crit Care. 2016 Apr 19;20(1):103
pubmed: 27091359
Intensive Care Med. 2017 Oct;43(10):1441-1452
pubmed: 28917004
Am J Respir Crit Care Med. 2017 Jan 1;195(1):57-66
pubmed: 27310484
Eur Respir J. 2013 Jul;42(1):280-3
pubmed: 23813311
Curr Opin Crit Care. 2021 Jun 1;27(3):282-289
pubmed: 33899818
Am J Respir Crit Care Med. 2002 Dec 15;166(12 Pt 1):1604-6
pubmed: 12471076
Crit Care Med. 1997 Jul;25(7):1187-90
pubmed: 9233746
Crit Care Explor. 2020 Apr 29;2(4):e0106
pubmed: 32426748
Trials. 2019 Jan 17;20(1):60
pubmed: 30654837
Crit Care Med. 2014 Feb;42(2):e152-6
pubmed: 24126442
Respir Physiol Neurobiol. 2017 Feb;236:23-28
pubmed: 27836647

Auteurs

Harry Etienne (H)

Experimental and Clinical Respiratory Neurophysiology, INSERM, UMRS1158, Sorbonne University, Paris, France.
Department of Thoracic Surgery, Tenon University Hospital, Paris, France.

Martin Dres (M)

Experimental and Clinical Respiratory Neurophysiology, INSERM, UMRS1158, Sorbonne University, Paris, France.
Department of Pulmonary Intensive Care Medicine, Pitie-Salpetriere University Hospital, Paris, France.

Julie Piquet (J)

Surgical Research Laboratory, Carpentier Foundation, Paris, France.

Laure Wingertsmann (L)

Pathology Platform, INSERM, UMRS1152, Paris, France.

Olivier Thibaudeau (O)

Pathology Platform, INSERM, UMRS1152, Paris, France.

Thomas Similowski (T)

Experimental and Clinical Respiratory Neurophysiology, INSERM, UMRS1158, Sorbonne University, Paris, France.
Department R3S, Pitie-Salpetriere University Hospital, Paris, France.

Jesus Gonzalez-Bermejo (J)

Experimental and Clinical Respiratory Neurophysiology, INSERM, UMRS1158, Sorbonne University, Paris, France.
Department of Pulmonary and Neuro-respiratory Rehabilitation, Pitie-Salpetriere University Hospital, Paris, France.

Jalal Assouad (J)

Experimental and Clinical Respiratory Neurophysiology, INSERM, UMRS1158, Sorbonne University, Paris, France.
Department of Thoracic Surgery, Tenon University Hospital, Paris, France.

Classifications MeSH