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High Frequency Spinal Cord Stimulation (HF‐SCS) to Provide Ventilatory Support in an Animal Model of Spinal Cord Injury
Author(s) -
DiMarco Anthony F.,
Kowalski Krzysztof E.
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.1064.17
Subject(s) - spinal cord injury , medicine , anesthesia , hyperventilation , spinal cord , stimulation , tidal volume , respiratory minute volume , phrenic nerve , ventilation (architecture) , airway , cardiology , respiratory system , mechanical engineering , psychiatry , engineering
Objective HF‐SCS is a novel technique of inspiratory muscle activation via spinal cord pathways. The purpose of this study was to evaluate the utility of HF‐SCS to provide long‐term ventilatory support utilizing intercostal/accessory muscle stimulation alone. Methods In 4 anesthetized dogs after bilateral phrenicotomy, electrical stimulation (300Hz, 1.2mA, 12 breath/min, 1.2s inspiratory time) was applied via a single electrode placed ventrally at the T2 spinal level over an arbitrary period of 5.5 hours. Results Mean airway pressures and inspired volumes were 29±1cmH 2 O and 445±7ml during the first and 27±1cmH 2 O and 450±12ml during the final hour of chronic pacing, respectively (NS). Throughout the period of stimulation, airway pressure generation and inspired volume production remained unchanged. Mean end‐tidal PCO 2 and SaO 2 were 40±1mmHg and 95±1% and 40±1mmHg and 96±1% during the first and final hour of pacing, respectively (NS). To further assess the capacity of the system to maintain artificial ventilation, stimulus parameters were then increased to induce hyperventilation for an additional 30 min. This resulted in a sustained fall in end‐tidal PCO 2 to 30±1 mmHg (p<0.05). Conclusion HF‐SCS has the potential to provide complete ventilatory support in subjects with ventilator‐dependent tetraplegia who lack adequate phrenic nerve function for diaphragm pacing. Support: NIH‐NINDS (R01NS064157)