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Restoring brain connectivity by phrenic nerve stimulation in sedated and mechanically ventilated patients. | LitMetric

Restoring brain connectivity by phrenic nerve stimulation in sedated and mechanically ventilated patients.

Commun Med (Lond)

Sorbonne Université, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière- Service de Médecine Intensive et Réanimation, Paris, France.

Published: November 2024

AI Article Synopsis

  • In critically ill patients, deep sedation and mechanical ventilation can lead to cognitive issues by suppressing the brain-diaphragm-lung interactions.
  • This study explored whether phrenic nerve stimulation could improve brain activity and connectivity in six patients with acute respiratory distress syndrome.
  • Results showed that phrenic stimulation, combined with mechanical ventilation, enhanced brain activity and synchronization similar to what occurs during natural diaphragmatic breathing, indicating its potential to restore important neural communication.

Article Abstract

Background: In critically ill patients, deep sedation and mechanical ventilation suppress the brain-diaphragm-lung axis and are associated with cognitive issues in survivors.

Methods: This exploratory crossover design study investigates whether phrenic nerve stimulation can enhance brain activity and connectivity in six deeply sedated, mechanically ventilated patients with acute respiratory distress syndrome.

Results: Our findings indicate that adding phrenic stimulation on top of invasive mechanical ventilation in deeply sedated, critically ill, moderate acute respiratory distress syndrome patients increases cortical activity, connectivity, and synchronization in the frontal-temporal-parietal cortices.

Conclusions: Adding phrenic stimulation on top of invasive mechanical ventilation in deeply sedated, critically ill, moderate acute respiratory distress syndrome patients increases cortical activity, connectivity, and synchronization. The observed changes resemble those during diaphragmatic breathing in awake humans. These results suggest that phrenic nerve stimulation has the potential to restore the brain-diaphragm-lung crosstalk when it has been shut down or impaired by mechanical ventilation and sedation. Further research should evaluate the clinical significance of these results.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574298PMC
http://dx.doi.org/10.1038/s43856-024-00662-0DOI Listing

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