{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:28:10Z","timestamp":1787610490855,"version":"build-2736575974"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"the General Project of Geriatric Research and Health in Jiangsu Province","award":["LKM2023042"],"award-info":[{"award-number":["LKM2023042"]}]},{"name":"the General Project of Geriatric Research and Health in Jiangsu Province","award":["LKM2023042"],"award-info":[{"award-number":["LKM2023042"]}]},{"name":"Science and Technology Development Project of Chinese Medicine in Jiangsu Province","award":["MS2023124"],"award-info":[{"award-number":["MS2023124"]}]},{"name":"Science and Technology Development Project of Chinese Medicine in Jiangsu Province","award":["MS2023124"],"award-info":[{"award-number":["MS2023124"]}]},{"name":"Science and Technology Project of Lianyungang City","award":["SF2213"],"award-info":[{"award-number":["SF2213"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-04352-2","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T14:39:15Z","timestamp":1748875155000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effects of external diaphragmatic pacing with neurally adjusted ventilatory assist on diaphragm function in AECOPD patients"],"prefix":"10.1038","volume":"15","author":[{"given":"Yuliang","family":"Sheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuwen","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caihong","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifang","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"4352_CR1","doi-asserted-by":"crossref","unstructured":"Agust\u00ed, A. et al. Global initiative for chronic obstructive lung disease 2023 report: GOLD executive Summary. Eur. Respir J., 61(4). (2023).","DOI":"10.1183\/13993003.00239-2023"},{"issue":"10342","key":"4352_CR2","doi-asserted-by":"publisher","first-page":"2227","DOI":"10.1016\/S0140-6736(22)00470-6","volume":"399","author":"SA Christenson","year":"2022","unstructured":"Christenson, S. A. et al. Chronic obstructive pulmonary disease. Lancet 399 (10342), 2227\u20132242 (2022).","journal-title":"Lancet"},{"key":"4352_CR3","doi-asserted-by":"crossref","unstructured":"Kim, V. & Aaron, S. D. What is a COPD exacerbation? Current definitions, pitfalls, challenges and opportunities for improvement. Eur. Respir J., 52(5). (2018).","DOI":"10.1183\/13993003.01261-2018"},{"issue":"3","key":"4352_CR4","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.arbres.2016.07.008","volume":"53","author":"I Dot","year":"2017","unstructured":"Dot, I. et al. Diaphragm dysfunction in mechanically ventilated Patients. Arch. Bronconeumol. 53 (3), 150\u2013156 (2017).","journal-title":"Arch. Bronconeumol."},{"issue":"4","key":"4352_CR5","first-page":"1040","volume":"153","author":"GS Supinski","year":"2018","unstructured":"Supinski, G. S. et al. Diaphragm Dysfunct. Crit. Illness Chest, 153(4): 1040\u20131051. (2018).","journal-title":"Diaphragm Dysfunct. Crit. Illness Chest"},{"issue":"5","key":"4352_CR6","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1007\/s00134-015-4125-2","volume":"42","author":"B Jung","year":"2016","unstructured":"Jung, B. et al. Diaphragmatic dysfunction in patients with ICU-acquired weakness and its impact on extubation failure. Intensive Care Med. 42 (5), 853\u2013861 (2016).","journal-title":"Intensive Care Med."},{"issue":"7","key":"4352_CR7","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1164\/rccm.202003-0655CP","volume":"202","author":"EC Goligher","year":"2020","unstructured":"Goligher, E. C. et al. Lung- and Diaphragm-Protective Ventilation. Am. J. Respir Crit. Care Med. 202 (7), 950\u2013961 (2020).","journal-title":"Am. J. Respir Crit. Care Med."},{"issue":"1","key":"4352_CR8","first-page":"58","volume":"21","author":"P Navalesi","year":"2015","unstructured":"Navalesi, P. & Longhini, F. Neurally adjusted ventilatory assist. Curr. Opin. Crit. Care. 21 (1), 58\u201364 (2015).","journal-title":"Curr. Opin. Crit. Care"},{"issue":"1","key":"4352_CR9","doi-asserted-by":"publisher","first-page":"53","DOI":"10.4187\/respcare.07122","volume":"65","author":"S Tajamul","year":"2020","unstructured":"Tajamul, S. et al. Neurally-Adjusted ventilatory assist versus noninvasive pressure support ventilation in COPD exacerbation: the NAVA-NICE Trial. Respir Care. 65 (1), 53\u201361 (2020).","journal-title":"Respir Care"},{"issue":"6","key":"4352_CR10","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1097\/ALN.0000000000003207","volume":"132","author":"L Liu","year":"2020","unstructured":"Liu, L. et al. Neurally adjusted ventilatory assist versus pressure support ventilation in difficult weaning: A randomized Trial. Anesthesiology 132 (6), 1482\u20131493 (2020).","journal-title":"Anesthesiology"},{"issue":"12","key":"4352_CR11","doi-asserted-by":"publisher","first-page":"2327","DOI":"10.1007\/s00134-020-06181-5","volume":"46","author":"RM Kacmarek","year":"2020","unstructured":"Kacmarek, R. M. et al. Neurally adjusted ventilatory assist in acute respiratory failure: A randomized controlled trial. Intensive Care Med. 46 (12), 2327\u20132337 (2020).","journal-title":"Intensive Care Med."},{"issue":"1","key":"4352_CR12","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1186\/s12931-019-1265-x","volume":"20","author":"T Shimatani","year":"2019","unstructured":"Shimatani, T. et al. Neurally adjusted ventilatory assist mitigates ventilator-induced diaphragm injury in rabbits. Respir Res. 20 (1), 293 (2019).","journal-title":"Respir Res."},{"issue":"1","key":"4352_CR13","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1186\/s12890-021-01677-2","volume":"21","author":"M Sot\u00e1k","year":"2021","unstructured":"Sot\u00e1k, M. et al. Phrenic nerve stimulation prevents diaphragm atrophy in patients with respiratory failure on mechanical ventilation. BMC Pulm Med. 21 (1), 314 (2021).","journal-title":"BMC Pulm Med."},{"key":"4352_CR14","doi-asserted-by":"publisher","first-page":"35725","DOI":"10.1038\/srep35725","volume":"6","author":"T Breuer","year":"2016","unstructured":"Breuer, T. et al. Kinetics of ventilation-induced changes in diaphragmatic metabolism by bilateral phrenic pacing in a piglet model. Sci. Rep. 6, 35725 (2016).","journal-title":"Sci. Rep."},{"issue":"3","key":"4352_CR15","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1164\/rccm.201502-0363OC","volume":"195","author":"SC Reynolds","year":"2017","unstructured":"Reynolds, S. C. et al. Mitigation of Ventilator-induced diaphragm atrophy by transvenous phrenic nerve Stimulation. Am. J. Respir Crit. Care Med. 195 (3), 339\u2013348 (2017).","journal-title":"Am. J. Respir Crit. Care Med."},{"issue":"20","key":"4352_CR16","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.21037\/atm-22-4145","volume":"10","author":"Q Bao","year":"2022","unstructured":"Bao, Q. et al. The effects of external diaphragmatic pacing on diaphragm function and weaning outcomes of critically ill patients with mechanical ventilation: a prospective randomized study. Ann. Transl Med. 10 (20), 1100 (2022).","journal-title":"Ann. Transl Med."},{"issue":"1","key":"4352_CR17","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s00134-016-4524-z","volume":"43","author":"M Zambon","year":"2017","unstructured":"Zambon, M. et al. Assessment of diaphragmatic dysfunction in the critically ill patient with ultrasound: a systematic review. Intensive Care Med. 43 (1), 29\u201338 (2017).","journal-title":"Intensive Care Med."},{"key":"4352_CR18","doi-asserted-by":"crossref","unstructured":"Shiraishi, M. et al. Diaphragmatic excursion correlates with exercise capacity and dynamic hyperinflation in COPD patients. ERJ Open. Res., 6(4). (2020).","DOI":"10.1183\/23120541.00589-2020"},{"issue":"4","key":"4352_CR19","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.55730\/1300-0144.5435","volume":"52","author":"C Topcuo\u011flu","year":"2022","unstructured":"Topcuo\u011flu, C. et al. Examination of diaphragm thickness, mobility and thickening fraction in individuals with COPD of different severity. Turk. J. Med. Sci. 52 (4), 1288\u20131298 (2022).","journal-title":"Turk. J. Med. Sci."},{"issue":"8","key":"4352_CR20","doi-asserted-by":"publisher","first-page":"591","DOI":"10.4103\/ija.ija_229_22","volume":"66","author":"R Saravanan","year":"2022","unstructured":"Saravanan, R. et al. Role of diaphragm ultrasound in weaning mechanically ventilated patients: A prospective observational study. Indian J. Anaesth. 66 (8), 591\u2013598 (2022).","journal-title":"Indian J. Anaesth."},{"issue":"12","key":"4352_CR21","doi-asserted-by":"publisher","first-page":"2408","DOI":"10.12998\/wjcc.v8.i12.2408","volume":"8","author":"A Boussuges","year":"2020","unstructured":"Boussuges, A. et al. Assessment of diaphragmatic function by ultrasonography: current approach and perspectives. World J. Clin. Cases. 8 (12), 2408\u20132424 (2020).","journal-title":"World J. Clin. Cases"},{"issue":"1","key":"4352_CR22","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1097\/EJA.0000000000001261","volume":"38","author":"M Scharffenberg","year":"2021","unstructured":"Scharffenberg, M. et al. Comparative effects of neurally adjusted ventilatory assist and variable pressure support on lung and diaphragmatic function in a model of acute respiratory distress syndrome: A randomised animal study. Eur. J. Anaesthesiol. 38 (1), 32\u201340 (2021).","journal-title":"Eur. J. Anaesthesiol."},{"key":"4352_CR23","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.hrtlng.2022.01.016","volume":"53","author":"V Hadda","year":"2022","unstructured":"Hadda, V. et al. Effects of neurally adjusted ventilation assist (NAVA) and conventional modes of mechanical ventilation on diaphragm functions: A randomized controlled trial. Heart Lung. 53, 36\u201341 (2022).","journal-title":"Heart Lung"},{"issue":"1","key":"4352_CR24","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/s13054-017-1714-1","volume":"21","author":"Q Sun","year":"2017","unstructured":"Sun, Q. et al. Effects of neurally adjusted ventilatory assist on air distribution and dead space in patients with acute exacerbation of chronic obstructive pulmonary disease. Crit. Care. 21 (1), 126 (2017).","journal-title":"Crit. Care"},{"issue":"2","key":"4352_CR25","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1007\/s10877-021-00668-2","volume":"36","author":"G Cammarota","year":"2022","unstructured":"Cammarota, G. et al. Effects of varying levels of inspiratory assistance with pressure support ventilation and neurally adjusted ventilatory assist on driving pressure in patients recovering from hypoxemic respiratory Failure. J. Clin. Monit. Comput. 36 (2), 419\u2013427 (2022).","journal-title":"J. Clin. Monit. Comput."},{"issue":"6","key":"4352_CR26","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1007\/s00134-013-2898-8","volume":"39","author":"P Blankman","year":"2013","unstructured":"Blankman, P. et al. Ventilation distribution measured with EIT at varying levels of pressure support and neurally adjusted ventilatory assist in patients with ALI. Intensive Care Med. 39 (6), 1057\u20131062 (2013).","journal-title":"Intensive Care Med."},{"issue":"10","key":"4352_CR27","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1164\/rccm.202107-1709OC","volume":"205","author":"M Dres","year":"2022","unstructured":"Dres, M. et al. Randomized clinical study of temporary transvenous phrenic nerve stimulation in Difficult-to-Wean Patients. Am. J. Respir Crit. Care Med. 205 (10), 1169\u20131178 (2022).","journal-title":"Am. J. Respir Crit. Care Med."},{"issue":"10","key":"4352_CR28","doi-asserted-by":"publisher","first-page":"1988","DOI":"10.1111\/aor.14244","volume":"46","author":"C Keogh","year":"2022","unstructured":"Keogh, C. et al. Non-invasive phrenic nerve stimulation to avoid ventilator-induced diaphragm dysfunction in critical care. Artif. Organs. 46 (10), 1988\u20131997 (2022).","journal-title":"Artif. Organs"},{"issue":"10","key":"4352_CR29","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1007\/s00134-022-06760-8","volume":"48","author":"IS Morris","year":"2022","unstructured":"Morris, I. S., Dres, M. & Goligher, E. C. Phrenic nerve stimulation to protect the diaphragm, lung, and brain during mechanical ventilation. Intensive Care Med. 48 (10), 1299\u20131301 (2022).","journal-title":"Intensive Care Med."},{"issue":"5","key":"4352_CR30","doi-asserted-by":"publisher","first-page":"602","DOI":"10.4187\/respcare.10568","volume":"68","author":"G Mueller","year":"2023","unstructured":"Mueller, G. et al. Safety and feasibility of noninvasive electromagnetic stimulation of the phrenic Nerves. Respir Care. 68 (5), 602\u2013610 (2023).","journal-title":"Respir Care"}],"updated-by":[{"DOI":"10.1038\/s41598-025-10455-7","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000}}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-04352-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-04352-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-04352-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T17:24:01Z","timestamp":1757179441000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-04352-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,2]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4352"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-04352-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,2]]},"assertion":[{"value":"2 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 July 2025","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1038\/s41598-025-10455-7","URL":"https:\/\/doi.org\/10.1038\/s41598-025-10455-7","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This trial was approved by the ethics committee at The First People\u2019s Hospital of Lianyungang according to the requirements of Chinese clinical trial guidelines. All patients provided written informed consent before enrollment.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"19340"}}