Intercostal Muscle Pacing with High Frequency Spinal Cord Stimulation in Dogs

Respir Physiol Neurobiol, 2010 · DOI: 10.1016/j.resp.2010.03.017 · Published: May 31, 2010

Simple Explanation

This study explores a new method of activating inspiratory muscles using high-frequency spinal cord stimulation (HF-SCS). The technique involves stimulating spinal cord pathways to activate inspiratory muscles more naturally. The study aims to determine if activating only the intercostal muscles, using HF-SCS, can maintain artificial ventilation in dogs after spinal cord injury and phrenic nerve damage. The results showed that HF-SCS could maintain ventilation in dogs, suggesting it could be a potential method for restoring ventilation in ventilator-dependent tetraplegics who cannot use diaphragm pacing.

Study Duration

6 Hours

Participants

7 anesthetized mongrel dogs

Evidence Level

Not specified

Key Findings

1
High-frequency spinal cord stimulation (HF-SCS) can maintain artificial ventilation by activating intercostal muscles alone in dogs with spinal cord injury and bilateral phrenicotomy.
2
During 5.5 hours of continuous HF-SCS, end-tidal PCO2 and oxygen saturation remained stable, indicating no system fatigue.
3
Single motor unit firing frequencies of intercostal muscles during HF-SCS were similar to those observed during spontaneous breathing, suggesting a more physiological muscle activation pattern.

Research Summary

This study investigated the feasibility of using high-frequency spinal cord stimulation (HF-SCS) to activate intercostal muscles for artificial ventilation in dogs with spinal cord injury. The results demonstrated that HF-SCS could maintain stable ventilation for extended periods without fatigue, and could induce hyperventilation with increased stimulus parameters. The findings suggest that HF-SCS has the potential to provide an alternative method of ventilatory support for tetraplegic patients who are not suitable candidates for diaphragm pacing.

Practical Implications

Alternative Ventilation Method

HF-SCS could offer a viable alternative for ventilator-dependent tetraplegics who cannot undergo diaphragm pacing due to phrenic nerve damage.

Improved Physiological Activation

HF-SCS provides a more physiological pattern of muscle activation compared to conventional methods, potentially reducing muscle fatigue and improving long-term outcomes.

Clinical Application Potential

This technique can be combined with unilateral phrenic nerve stimulation or used as a superior option for all patients with ventilator-dependent tetraplegia.

Study Limitations

1
The specific spinal cord tracts mediating intercostal muscle activation via this technique are not known and may not exist in humans.
2
The novelty of this method of electrical activation of the inspiratory muscles presents unique potential sources of system fatigue.
3
The difference in shape of the thorax between species may represent greater impediment to clinical translation.

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