Source: Annual Congress 2008 - Progress and a new era for noninvasive mechanical ventilation
Disease area: Respiratory critical care

Abstract

Positive pressure ventilation injures especially the already injured lung and atrophy of respiratory muscles can be observed within hours1. Magnetic stimulation appears to be a more physiologic alternative. It has been used to ventilate dogs2 and to induce single tidal breaths in three patients3. However, it is not known if and to which extent magnetic stimulation is able to ventilate humans sufficiently.
In 10 healthy volunteers, we stimulated the phrenic nerves at the posterior sides of the sternocleidomastoid muscles using a MagStimRapid and a MagStim SuperRapid stimulator. During 1 minute we stimulated 9 times with a frequency of 25Hz for 1.1sec using 20, 30, 40 and 50% of the maximum stimulation energy.
Bilateral stimulation was not painful and well tolerated. Only 20% of the maximum stimulation energy already achieved sufficient minute ventilation (MV) in almost all volunteers (median, minimum-maximum; 5.9, 4.3-14.6 l/min). MV increased remarkably at higher energy levels (p<0.0001): 30% of the energy already generated hyperventilation in most (10.4, 5.6-21.0 l/min) and 40% in all volunteers (13.2, 7.8-20.7 l/min).
Although unilateral stimulation was less effective than bilateral (p<0.0001) sufficient MV was achieved in almost all volunteers. MV did not differ between left and right unilateral stimulation (p>0.2).
For the first time we demonstrated that bilateral and even unilateral cervical magnetic stimulation represent a well-tolerated and highly effective mode for artificial respiration in humans.
1. DeRuisseau KC et al. AJRCCM 2005; 98, 1314-21.
2. Geddes LA et al. Ann Biomed Eng 1993; 21, 193-7.
3. Geddes LA et al. Trans Biomed Eng 1991; 38, 1047-8.

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Citations should be made in the following way:
B. Sander, F. Homringhausen, T. Dieck, C. Tschan, J. Steffens, J. Ahrens, H. Hecker, S. Piepenbrock, K. Raymondos (Hanover, Germany). Magnetic ventilation – first evaluation of artificial ventilation with magnetic stimulation in humans. Eur Respir J 2008; 32: Suppl. 52, 362

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