{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:18:29Z","timestamp":1792635509104,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T00:00:00Z","timestamp":1485907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Ventilator-induced diaphragm dysfunction is a significant contributor to weaning difficulty in ventilated critically ill patients. It has been hypothesized that electrically pacing the diaphragm during mechanical ventilation could reduce diaphragm dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We tested a novel, central line catheter\u2013based, transvenous phrenic nerve pacing therapy for protecting the diaphragm in sedated and ventilated pigs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighteen Yorkshire pigs were studied. Six pigs were sedated and mechanically ventilated for 2.5 days with pacing on alternate breaths at intensities that reduced the ventilator pressure\u2013time product by 20\u201330%. Six matched subjects were similarly sedated and ventilated but were not paced. Six pigs served as never-ventilated, never-paced control animals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Cumulative duration of pacing therapy ranged from 19.7 to 35.7 hours. Diaphragm thickness assessed by ultrasound and normalized to initial value showed a significant decline in ventilated\u2013not paced but not in ventilated-paced subjects (0.84 [interquartile range (IQR), 0.78\u20130.89] vs. 1.10 [IQR, 1.02\u20131.24]; P\u2009=\u20090.001). Compared with control animals (24.6 \u03bcm2\/kg; IQR, 21.6\u201326.0), median myofiber cross-sectional areas normalized to weight and sarcomere length were significantly smaller in the ventilated\u2013not paced (17.9 \u03bcm2\/kg; IQR, 15.3\u201323.7; P\u2009=\u20090.005) but not in the ventilated-paced group (24.9 \u03bcm2\/kg; IQR, 16.6\u201327.3; P\u2009=\u20090.351). After 60 hours of mechanical ventilation all six ventilated-paced subjects tolerated 8 minutes of intense phrenic stimulation, whereas three of six ventilated\u2013not paced subjects did not (P\u2009=\u20090.055). There was a nonsignificant decrease in diaphragm tetanic force production over the experiment in the ventilated-paced and ventilated\u2013not paced groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results suggest that early transvenous phrenic nerve pacing may mitigate ventilator-induced diaphragm dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201502-0363oc","type":"journal-article","created":{"date-parts":[[2016,8,8]],"date-time":"2016-08-08T15:32:56Z","timestamp":1470670376000},"page":"339-348","source":"Crossref","is-referenced-by-count":101,"title":["Mitigation of Ventilator-induced Diaphragm Atrophy by Transvenous Phrenic Nerve Stimulation"],"prefix":"10.1093","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2624-640X","authenticated-orcid":false,"given":"Steven 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and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc-Andr\u00e9","family":"Nolette","sequence":"additional","affiliation":[{"name":"Lungpacer Medical Inc., Burnaby, British Columbia, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam","family":"Sadarangani","sequence":"additional","affiliation":[{"name":"Lungpacer Medical Inc., Burnaby, British Columbia, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo A.","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Lungpacer Medical Inc., Burnaby, British Columbia, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Bruulsema","sequence":"additional","affiliation":[{"name":"Lungpacer Medical Inc., Burnaby, British Columbia, Canada; and"},{"name":"Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Hannigan","sequence":"additional","affiliation":[{"name":"Lungpacer Medical Inc., Burnaby, British Columbia, Canada; and"},{"name":"Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason W.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Rohrs","sequence":"additional","affiliation":[{"name":"Department of Respiratory Therapy, Royal Columbian Hospital, New Westminster, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Zurba","sequence":"additional","affiliation":[{"name":"Department of Respiratory Therapy, 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