| Title: |
Ultrasound guided transcutaneous phrenic nerve stimulation in critically ill patients: a new method to evaluate diaphragmatic function |
| Authors: |
Capdevila, Mathieu; de Jong, Audrey; Belafia, Fouad; Vonarb, Aurelie; Carr, Julie; Molinari, Nicolas; Choquet, Olivier; Capdevila, Xavier; Jaber, Samir |
| Contributors: |
Hôpital Saint Eloi CHU Montpellier; Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp); Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM); Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM); Médecine de précision par intégration de données et inférence causale (PREMEDICAL); Centre Inria d'Université Côte d'Azur; Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut Desbrest d'Epidémiologie et de Santé Publique (IDESP); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM); Hôpital Lapeyronie CHU Montpellier; Institut des Neurosciences de Montpellier (INM) |
| Source: |
ISSN: 0003-3022 ; Anesthesiology ; https://hal.science/hal-04751240 ; Anesthesiology, 2025, 142 (3), pp.522-531. ⟨10.1097/ALN.0000000000005267⟩. |
| Publisher Information: |
CCSD; Lippincott, Williams & Wilkins |
| Publication Year: |
2025 |
| Collection: |
Université de Montpellier: HAL |
| Subject Terms: |
[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]; [SDV.IB]Life Sciences [q-bio]/Bioengineering; [SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph] |
| Description: |
International audience ; Background : Diaphragm dysfunction is common in intensive care unit and associated with weaning failure and mortality. Diagnosis gold standard is the transdiaphragmatic or tracheal pressure induced by magnetic phrenic nerve stimulation. However, the equipment is not commonly available and requires specific technical skills. We aimed to evaluate ultrasound guided transcutaneous phrenic nerve stimulation for daily bedside assessment of diaphragm function by targeted electrical phrenic nerve stimulation. Methods : In this randomized cross-over study we compared a new method of ultrasound guided transcutaneous electrical phrenic nerve stimulation (SONOTEPS method) using a peripheral nerve stimulator, with the magnetic phrenic nerve stimulation. Intensive care unit adult patients under mechanical ventilation with a Richmond-Agitation-Sedation-Scale score of -4 or -5 were included. Each patient received the two methods of stimulation, in a randomized order. The primary outcome was the tracheal pressure (Ptrach) induced by stimulation. Results : We analyzed 232 measures of Ptrach from 116 patients of whom 77 presented a diaphragm dysfunction (Ptrach < 11 cmH2O) and 50 a severe diaphragm dysfunction (Ptrach < 8 cmH2O). The Passing-Bablok regression showed no significant differences (intercept A of -0.03 [CI95:-0.83-0.52] and slope B of 0.98 [CI95:0.90-1.05]) between SONOTEPS method and magnetic stimulation which were positively correlated (R²=0.639). The mean bias was -1.08 (CI95 5.02, -7.18) cmH2O. The receiver operating curves showed an excellent performance for the diagnosis of diaphragm dysfunction and severe diaphragm dysfunction with respectively an area under curve of 0.90 (CI95 0.83-0.97) and 0.88 (CI95 0.82-0.95). This performance was not significantly affected by the body mass index or the presence of a neck catheter. Conclusions : The SONOTEPS method is a simple and accurate tool for bedside assessment of diaphragm function with ultrasound guided transcutaneous phrenic nerve ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1097/ALN.0000000000005267 |
| Availability: |
https://hal.science/hal-04751240; https://hal.science/hal-04751240v1/document; https://hal.science/hal-04751240v1/file/2025%20Capdevila%20et%20al.,%20Ultrasound.pdf; https://doi.org/10.1097/ALN.0000000000005267 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.DEC53C97 |
| Database: |
BASE |