Universität zu Köln

Kandhari, Sachin, Sharma, Dewaker, Tomar, Amit Kumar, Matis, Georgios, Lavrov, Igor A. and Majumdar, Pritam (2022). Epidural electrical spinal cord stimulation of the thoracic segments (T2-T5) facilitates respiratory function in patients with complete spinal cord injury. Respir. Physiol. Neuro., 300. AMSTERDAM: ELSEVIER. ISSN 1878-1519

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Abstract

Introduction: Patients with high cervical Spinal Cord Injury (SCI) usually require mechanical ventilation support. Phrenic Nerve Stimulation (PNS) both direct and indirect is the main alternative for these patients to wean off ventilator although PNS has several limitations and phrenic nerve could be also damaged after cervical spinal cord injury.Objective: In this study, we assessed if the spinal cord Epidural Electrical Stimulation (EES) at the segments T2-T5, related to intercostal muscles, can facilitate respiratory function and particularly inspired tidal volume during mechanic ventilation.Methods: Two patients with a high cervical injury were selected for this study with ethical committee permission and under review board supervision. A phrenic nerve conduction study with diaphragm electromyography (DEMG) was performed before and after trial of EES.Results: Results demonstrate that EES at T2-T5 substantially increase the inspired volume. The results of this study also demonstrate that EES at spinal segments T2-T5 can bring patients dependent from mechanical ventilation to pressure support (on CPAP), preventing Baro-trauma and other complications related to mechanical ventilation.Conclusion: These findings suggest that tested approach applied alone or in combination with the phrenic nerve stimulation could help to reduce time on mechanical ventilation and related complications.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kandhari, Sachin UNSPECIFIED UNSPECIFIED UNSPECIFIED Sharma, Dewaker UNSPECIFIED UNSPECIFIED UNSPECIFIED Tomar, Amit Kumar UNSPECIFIED UNSPECIFIED UNSPECIFIED Matis, Georgios UNSPECIFIED UNSPECIFIED UNSPECIFIED Lavrov, Igor A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Majumdar, Pritam UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-678213
DOI:	10.1016/j.resp.2022.103885
Journal or Publication Title:	Respir. Physiol. Neuro.
Volume:	300
Date:	2022
Publisher:	ELSEVIER
Place of Publication:	AMSTERDAM
ISSN:	1878-1519
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROVIDE ARTIFICIAL-VENTILATION; INSPIRATORY MUSCLES; NATIONAL INSTITUTES; EXPIRATORY MUSCLES; RESTORE COUGH; INTERCOSTAL; ACTIVATION; DIAPHRAGM Multiple languages Physiology; Respiratory System Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67821