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Phrenic nerve stimulation

Published online by Cambridge University Press:  01 February 2008

I. Shehu  and
E. Peli
I. Shehu*
Affiliation:
University of Brescia, Institute of Anesthesiology-Intensive Care, Brescia, Italy
E. Peli
Affiliation:
University of Brescia, Institute of Anesthesiology-Intensive Care, Brescia, Italy
*
Correspondence to: Indrit Shehu, Institute of Anesthesiology-Intensive Care, University of Brescia, Piazzale Spedali Civili, 1–25125 Brescia, Italy. E-mail: [email protected]; Tel: +39 339 4576176; Fax: +39 30 3229306
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Summary

Weakness of the limbs and respiratory muscles has increasingly been found to be a frequent event that complicates the medical history of patients in Intensive Care. The problem normally affects more serious cases and presents as muscular weakness leading to flaccid paralysis and difficulty in weaning patients off mechanical ventilation. This latter sign leads the intensivist to suspect possible involvement of the neuromuscular respiratory system. Unfortunately, in-depth clinical assessment of the neuromuscular respiratory system is difficult with critically ill patients, and electrophysiological studies have been used instead to overcome this problem. Of these latter, electric and electromagnetic stimulation of the phrenic nerve have been successful (along with needle electromyography of the diaphragm) in identifying the causes of neuromuscular respiratory insufficiency, especially in Intensive Care. In this brief chapter, we will be discussing the technique of electric stimulation of the phrenic nerve and neuromuscular respiratory insufficiency within the field of critical illness polyneuropathy.

Keywords

CRITICAL CAREPOLYNEUROPATHYMUSCULAR DISEASESRESPIRATORY SYSTEMPHRENIC NERVEDIAPHRAGM
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue S42 , February 2008 , pp. 186 - 191
Copyright
Copyright © European Society of Anaesthesiology 2008

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References

1.Bolton, CF. Neuromuscular manifestations of critical illness. Muscle Nerve 2005; 32: 140–163.Google Scholar
2.Kelly, BJ, Matthay, MA. Prevalence and severity of neurologic dysfunction in critically ill patients. Influence on need for continued mechanical ventilation. Chest 1993; 104: 1818–1824.Google Scholar
3.Rochester, DF. The diaphragm contractile properties and fatigue. J Clin Invest 1985; 75: 1397–1402.CrossRefGoogle ScholarPubMed
4.Rochester, DF, Arora, NS, Braun, NM. Maximum contractile force of human diaphragm muscle, determined in vivo. Trans Am Clin Climatol Assoc 1981; 93: 200–208.Google Scholar
5.De Troyer, A, Borenstein, S, Cordier, R. Analysis of lung volume restriction in patients with respiratory muscle weakness. Thorax 1980; 35: 603–610.CrossRefGoogle ScholarPubMed
6.Fromageot, C, Lofaso, F, Annane, D et al. . Supine fall in lung volumes in the assessment of diaphragmatic weakness in neuromuscular disorders. Arch Phys Med Rehabil 2001; 82: 123–128.Google Scholar
7.Polkey, MI, Lyall, RA, Green, M et al. . Expiratory muscle function in amyotrophic lateral sclerosis. Am J Respir Crit Care Med 1998; 158: 734–741.Google Scholar
8.Bolton, CF. Clinical neurophysiology of the respiratory system. AAEM Minimonograph #40. Muscle Nerve 1993; 16: 808–818.CrossRefGoogle Scholar
9.Markand, ON, Kincaid, JC, Pourmand, RA et al. . Electrophysiologic evaluation of diaphragm by transcutaneous phrenic nerve stimulation. Neurology 1984; 34: 604–614.Google Scholar
10.Swensen, MR, Rubenstein, RS. Phrenic nerve conduction studies. Muscle Nerve 1992; 15: 597–603.Google Scholar
11.Similowski, T, Fleury, B, Launois, S et al. . Cervical magnetic stimulation: a new painless method for bilateral phrenic nerve stimulation in conscious humans. J Appl Physiol 1989; 67: 1311–1318.CrossRefGoogle ScholarPubMed
12.Olney, RK, So, YT, Goodin, DS et al. . A comparison of magnetic and electrical stimulation of peripheral nerves. Muscle Nerve 1990; 13: 957–963.CrossRefGoogle ScholarPubMed
13.Ono, S, Oishi, M, Du, CM et al. . Magnetic stimulation of peripheral nerves: comparison of magnetic stimulation with electrical stimulation. Electromyogr Clin Neurophysiol 1995; 35: 317–320.Google ScholarPubMed
14.Zifko, U, Remtulla, H, Power, K et al. . Transcortical and cervical magnetic stimulation with recording of the diaphragm. Muscle Nerve 1996; 19: 614–620.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
15.Chen, R, Collins, S, Remtulla, H et al. . Phrenic nerve conduction study in normal subjects. Muscle Nerve 1995; 18: 330–335.CrossRefGoogle ScholarPubMed
16.Wragg, S, Aquilina, R, Moran, J et al. . Comparison of cervical magnetic stimulation and bilateral percutaneous electrical stimulation of the phrenic nerves in normal subjects. Eur Respir J 1994; 7: 1788–1792.Google Scholar
17.Laghi, F, Harrison, MJ, Tobin, MJ. Comparison of magnetic and electrical phrenic nerve stimulation in assessment of diaphragmatic contractility. J Appl Physiol 1996; 80: 1731–1742.CrossRefGoogle ScholarPubMed
18.Chokroverty, S. Magnetic Stimulation in Clinical Neurophysiology. London: Butterworth, 1990.Google Scholar
19.Mills, GH, Kyroussis, D, Hamnegard, CH et al. . Unilateral magnetic stimulation of the phrenic nerve. Thorax 1995; 50: 1162–1172.CrossRefGoogle ScholarPubMed
20.Mills, G, Kyroussis, D, Hamnegard, CH et al. . Bilateral magnetic stimulation of the phrenic nerves from an anterolateral approach. Am J Respir Crit Care Med 1996; 154: 1099–1105.Google Scholar
21.Polkey, MI, Lyall, RA, Moxham, J, Leigh, PN. Respiratory aspects of neurological disease. J Neurol Neurosurg Psychiatry 1999; 66: 5–15.CrossRefGoogle ScholarPubMed
22.Zifko, U, Chen, R, Remtulla, H et al. . Respiratory electrophysiological studies in Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry 1996; 60: 191–194.CrossRefGoogle ScholarPubMed
23.Maher, J, Grand’Maison, F, Nicolle, MW et al. . Diagnostic difficulties in myasthenia gravis. Muscle Nerve 1998; 21: 577–583.Google Scholar
24.Nicolle, MW, Stewart, DJ, Remtulla, H et al. . Lambert–Eaton myasthenic syndrome presenting with severe respiratory failure. Muscle Nerve 1996; 19: 1328–1333.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
25.Bolton, CF, Young, GB, Zochodne, DW. The neurological complications of sepsis. Ann Neurol 1993; 33: 94–100.CrossRefGoogle ScholarPubMed
26.De Jonghe, B, Lefaucheur, JP, Sharshar, T, Outin, H. Critical illness neuromyopathy. Clin Pulm Med 2005; 12: 90–96.Google Scholar
27.Multz, AS, Aldrich, TK, Prezant, DJ et al. . Maximal inspiratory pressure is not a reliable test of inspiratory muscle strength in mechanically ventilated patients. Am Rev Respir Dis 1990; 142: 529–532.Google Scholar
28.Conti, G, Montini, L, Pennisi, MA et al. . A prospective, blinded evaluation of indexes proposed to predict weaning from mechanical ventilation. Intensive Care Med 2004; 30: 830–836.CrossRefGoogle ScholarPubMed
29.Bolton, CF, Gilbert, JJ, Hahn, AF et al. . Polyneuropathy in critically ill patients. J Neurol Neurosurg Psychiatry 1984; 47: 1223–1231.CrossRefGoogle ScholarPubMed
30.De Jonghe, B, Sharshar, T, Lefaucheur, JP et al. . Paresis acquired in the intensive care unit: a prospective multicenter study. JAMA 2002; 288: 2859–2867.CrossRefGoogle ScholarPubMed
31.Leijten, FS, Harinck-de Weerd, JE, Poortvliet, DC et al. . The role of polyneuropathy in motor convalescence after prolonged mechanical ventilation. JAMA 1995; 274: 1221–1225.Google Scholar
32.Druschky, A, Herkert, M, Radespiel-Troger, M et al. . Critical illness polyneuropathy: clinical findings and cell culture assay of neurotoxicity assessed by a prospective study. Intensive Care Med 2001; 27: 686–693.Google Scholar
33.Thiele, RI, Jakob, H, Hund, E et al. . Sepsis and catecholamine support are the major risk factors for critical illness polyneuropathy after open heart surgery. Thorac Cardiovasc Surg 2000; 48: 145–150.Google Scholar
34.Garnacho-Montero, J, Madrazo-Osuna, J, Garcia-Garmendia, JL et al. . Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients. Intensive Care Med 2001; 27: 1288–1296.Google Scholar
35.Garnacho-Montero, J, Amaya-Villar, R, Garcia-Garmendia, JL et al. . Effect of critical illness polyneuropathy on the withdrawal from mechanical ventilation and the length of stay in septic patients. Crit Care Med 2005; 33: 349–354.CrossRefGoogle ScholarPubMed
36.Seneff, MG, Zimmerman, JE, Knaus, WA et al. . Predicting the duration of mechanical ventilation. The importance of disease and patient characteristics. Chest 1996; 110: 469–479.Google Scholar
37.De Jonghe, B, Bastuji-Garin, S, Sharshar, T et al. . Does ICU-acquired paresis lengthen weaning from mechanical ventilation? Intensive Care Med 2004; 30: 1117–1121.Google Scholar
38.Witt, NJ, Zochodne, DW, Bolton, CF et al. . Peripheral nerve function in sepsis and multiple organ failure. Chest 1991; 99: 176–184.CrossRefGoogle ScholarPubMed
39.Zochodne, DW, Bolton, CF, Wells, GA et al. . Critical illness polyneuropathy. A complication of sepsis and multiple organ failure. Brain 1987; 110: 819–841.Google Scholar
40.Spitzer, AR, Giancarlo, T, Maher, L et al. . Neuromuscular causes of prolonged ventilator dependency. Muscle Nerve 1992; 15: 682–686.CrossRefGoogle ScholarPubMed
41.Maher, J, Rutledge, F, Remtulla, H et al. . Neuromuscular disorders associated with failure to wean from the ventilator. Intensive Care Med 1995; 21: 737–743.Google Scholar
42.Zifko, UA, Zipko, HT, Bolton, CF. Clinical and electrophysiological findings in critical illness polyneuropathy. J Neurol Sci 1998; 159: 186–193.Google Scholar