| Title: |
Phrenic Nerve Stimulation Decreases Biomarkers for Brain Injury in Deeply Sedated Mechanically Ventilated Moderate ARDS Patients |
| Authors: |
Bassi, T.; Rohrs, E.; Reynolds, S.C.; Decavèle, M.; Demoule, A.; Similowski, T.; Dres, M. |
| Source: |
American Journal of Respiratory and Critical Care Medicine ; volume 211, issue Supplement_1, page A1220-A1220 ; ISSN 1073-449X 1535-4970 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Description: |
INTRODUCTION: Preclinical studies have shown that mechanical ventilation (MV) is associated with increased serum concentration of biomarkers for brain injury. Restoring the respiratory drive by phrenic nerve stimulation in deeply sedated pigs led to a reduction in biomarkers for brain injury. This study investigated whether the preclinical findings of reduced biomarkers for brain injury were also observed in a clinical scenario by applying phrenic nerve stimulation in critically ill acute respiratory distress syndrome (ARDS) patients undergoing MV. METHODS: Twelve deeply sedated ARDS patients receiving invasive MV were included (ClinTrials.gov: NCT04844892). A central-line catheter embedded with electrodes was inserted via the left subclavian vein to stimulate the phrenic nerves bilaterally, in synchrony with MV. The study protocol was comprised of two hours without diaphragm neurostimulation (unpaced sessions), and two hours with diaphragm neurostimulation on every breath (paced sessions). All ventilator settings and administered medications remained unchanged during the study. Sedation infusions were also kept unchanged during the sessions. Blood samples for brain biomarkers (S100b, GFAP, UCHL-1, NSE, NfL and tau) were collected at baseline and the end of each session. We conducted an analysis comparing serum concentration at baseline versus at the study end (i.e., session 1 vs. session 4) using a paired Wilcoxon test due to the half-life of biomarkers for brain injury studied (between 30 minutes and 72 hours). P-values |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1164/ajrccm.2025.211.abstracts.a1220 |
| Availability: |
https://doi.org/10.1164/ajrccm.2025.211.abstracts.a1220; https://academic.oup.com/ajrccm/article-pdf/211/Supplement_1/A1220/67026483/ajrccm_211_abstracts_a1220.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.FF52C402 |
| Database: |
BASE |