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http://dx.doi.org/10.1172/JCI102040 | DOI Listing |
Intensive Care Med Exp
December 2023
Charité - Universitätsmedizin Berlin, Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany.
Side effects of mechanical ventilation, such as ventilator-induced diaphragmatic dysfunction (VIDD) and ventilator-induced lung injury (VILI), occur frequently in critically ill patients. Phrenic nerve stimulation (PNS) has been a valuable tool for diagnosing VIDD by assessing respiratory muscle strength in response to magnetic PNS. The detection of pathophysiologically reduced respiratory muscle strength is correlated with weaning failure, longer mechanical ventilation time, and mortality.
View Article and Find Full Text PDFBrain Commun
September 2022
Department of Neurosurgery, Robert Wood Johnson Medical School, Rutgers University, 10 Plum St., New Brunswick, NJ 08901, USA.
Mayo Clin Proc
September 2017
Department of Neurologic Surgery, Mayo Clinic, Rochester, MN. Electronic address:
Spinal cord injury (SCI) is a complex and devastating condition characterized by disruption of descending, ascending, and intrinsic spinal circuitry resulting in chronic neurologic deficits. In addition to limb and trunk sensorimotor deficits, SCI can impair autonomic neurocircuitry such as the motor networks that support respiration and cough. High cervical SCI can cause complete respiratory paralysis, and even lower cervical or thoracic lesions commonly result in partial respiratory impairment.
View Article and Find Full Text PDFAnasthesiol Intensivmed Notfallmed Schmerzther
September 2014
Gesa Leyk und Sven Hirscheld haben zu gleichen Teilen zum Manuskript beigetragen.
With 2000 new cases/year in Germany spinal cord injury (SCI) is quantitatively less important for intensive care medicine than, e.g., sepsis.
View Article and Find Full Text PDFJ Spinal Cord Med
March 2012
Department of Physical Medicine & Rehabilitation, University Hospital, NY, USA.
This article describes noninvasive acute and long-term management of the respiratory muscle paralysis of high spinal cord injury (SCI). This includes full-setting, continuous ventilatory support by noninvasive intermittent positive pressure ventilation (NIV) to support inspiratory muscles and mechanically assisted coughing (MAC) to support inspiratory and expiratory muscles. The NIV and MAC can also be used to extubate or decannulate 'unweanable' patients with SCI, to prevent intercurrent respiratory tract infections from developing into pneumonia and acute respiratory failure (ARF), and to eliminate tracheostomy and resort to costly electrophrenic/diaphragm pacing (EPP/DP) for most ventilator users, while permitting glossopharyngeal breathing (GPB) for security in the event of ventilator failure.
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