The induction of inspiration by delivering a burst of short-duration stimuli to body-surface electrodes is over a century old. The authors have used the term electroventilation to describe the technique. Inspiration can be produced with stimuli applied to electrodes placed bilaterally at the base of the neck, over the phrenic nerve motor points. Transchest electrodes placed anterior to the axillae can be used to stimulate the long thoracic and phrenic nerves. Paraxiphoid electrodes can be used to stimulate the phrenic nerves as they enter the diaphragm. With any of these electrode placements, inspired volumes in excess of spontaneous tidal volumes can be achieved in man, baboon, and dog. Of major importance is the need to use short-duration (less than 10-microseconds) pulses in the train of stimuli that produces contraction of the inspiratory muscles. The duration of inspiration is determined by the duration of the train, which is typically 0.5-1 s. The use of short-duration pulses minimizes the risk of producing cardiac arrhythmias and results in very little sensation at the skin.
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Intern Med
January 2025
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
We herein report the first case of dyspnea with hemidiaphragm elevation in a 68-year-old woman with active giant cell arteritis (GCA), including successful treatment. Contrast-enhanced computed tomography showed a reduced density of the left ophthalmic artery and the left superficial temporal artery with increased soft tissue compared to the other side, indicating that the GCA had flared up and suggesting that the hemidiaphragm elevation might be caused by vasculitis-associated ischemia of the right phrenic nerve. Hemidiaphragm paralysis due to vasculitis-associated ischemia in patients with GCA needs to be distinguished from local infection, tumors, and hepatomegaly, which are the major causes of hemidiaphragm elevation.
View Article and Find Full Text PDFJ Med Ultrasound
November 2024
Department of Anesthesiology, Ibra Hospital, Ibra, Oman.
Background: It is very well known that the supraclavicular nerve (SCN) which occupies the inferior part of the superficial cervical plexus basically originates from the ventral rami of C2-C4, then travels caudally into the investing layer of the deep cervical fascia (IL-DCF) alternatively termed the "prevertebral fascia."
Methods: This cadaveric study (a total of 6 soft-embalmed cadavers and bilateral dissections, i.e.
Muscle Nerve
January 2025
Department of Neurosciences and Mental Health, ULS Hospital de Santa Maria, Lisbon, Portugal.
Introduction/aims: Literature on the role of gastrostomy and noninvasive ventilation (NIV) in primary lateral sclerosis (PLS) is limited. We aim to investigate whether PLS patients develop dysphagia requiring feeding tubes or respiratory failure necessitating NIV.
Methods: We conducted a retrospective study of PLS patients with a definite diagnosis followed at our center (1994-2024).
J Interv Card Electrophysiol
January 2025
Department of Cardiology, Thorax Center, Cardiovascular Institute, Erasmus MC, Rotterdam, the Netherlands.
Introduction: A hybrid approach with very high-power short-duration (vHPSD) posteriorly and ablation-index guided HPSD (50 W) anteriorly seems to be an optimal balance between efficiency and effectiveness for point-by-point pulmonary vein isolation (PVI). The aim of the current study is to compare vHPSD/HPSD ablation to cryoballoon ablation (CBA) in patients with symptomatic atrial fibrillation (AF).
Methods And Results: In this retrospective single-center study, we identified 110 consecutive patients who underwent their first PVI with either vHPSD/HPSD (n = 54) or CBA (n = 56).
Int J Mol Sci
December 2024
Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Aging disrupts multiple homeostatic processes, including autophagy, a cellular process for the recycling and degradation of defective cytoplasmic structures. Acute treatment with the autophagy inhibitor chloroquine blunts the maximal forces generated by the diaphragm muscle, but the mechanisms underlying neuromuscular dysfunction in old age remain poorly understood. We hypothesized that chloroquine treatment increases the presynaptic retention of the styryl dye FM 4-64 following high-frequency nerve stimulation, consistent with the accumulation of unprocessed bulk endosomes.
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