Gh. Mills et al., BILATERAL MAGNETIC STIMULATION OF THE PHRENIC NERVES FROM AN ANTEROLATERAL APPROACH, American journal of respiratory and critical care medicine, 154(4), 1996, pp. 1099-1105
Citations number
20
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
We investigated whether bilateral magnetic stimulation of the phrenic
nerves from an anterolateral approach (BAMPS) could combine the reprod
ucibility and ease of use of cervical magnetic stimulation (CMS) with
the specificity of bilateral electrical stimulation (BES) and whether
it could be used in supine subjects. We placed two double 43-mm coils
over the phrenic nerves in the neck. BAMPS produced supramaximal phren
ic stimulation by electromyogram (EMG) assessment in six of seven subj
ects. There was no significant difference in the twitch gastric pressu
re/twitch esophageal pressure ratio (twitch Pgas/Pes) between BAMPS (1
.2) and BES (1.3). Both differed from CMS (0.9, p < 0.001). The effect
of a change in posture on twitch transdiaphragmatic pressure (TwPdi)
and Pgas/Pes ratio was the same for BAMPS and BES. In normal subjects
and patients BAMPS correlated significantly with BES (r = 0.97), maxim
al sniffs (r = 0.85), and CMS (r = 0.92). The mean difference between
BAMPS and BES was 0.3 cm H2O (SD = 2.3). Two-minute maximal isocapnic
ventilation produced a 19% fall in TwPdi elicited by BAMPS. BAMPS is e
asy, well tolerated and can be used in the supine subject. TwPdi and p
artitioning of Pes and Pgas were very close for BAMPS and BES, suggest
ing similar specificity for the diaphragm.