New Intramuscular Electrodes for Respiratory Pacing in SCI

用于 SCI 呼吸起搏的新型肌内电极

• 批准号: 8398798
• 负责人: James S. Walter
• 金额: --
• 依托单位: EDWARD HINES JR VA HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8398798
• 关键词: Abdomen; Abdominal Muscles; Acute; Air; Anesthesia procedures; Animal Model; Animals; Apnea; Autopsy; Bilateral; Canis familiaris; Caring; Central tendon of diaphragm structure; Cervical; Cervical spinal cord injury; Charge; Chest; Coughing; Data; Electrodes; Forelimb; Frequencies; Hyperventilation; Implanted Electrodes; Individual; Intercostal Muscles; Intramuscular; Investigation; Ions; Measures; Mechanical ventilation; Methods; Modeling; Motor; Muscle; Nerve; Palpation; Peripheral Blood Mononuclear Cell; Pneumonia; Protocols documentation; Ramp; Resistance; Respiration; Respiratory Diaphragm; Respiratory Muscles; Solutions; Spinal; Spinal cord injury; Spinal cord injury patients; Spinal nerve structure; Structure of phrenic nerve; Students; Surface; Synapses; Technology Transfer; Tendon structure; Testing; Tidal Volume; United States Department of Veterans Affairs; Ventilator; abdominal pressure; acronyms; base; esophagus pressure; improved; mortality; pressure; programs; respiratory; response

DESCRIPTION (provided by applicant): Complete cervical spinal cord injury (SCI) usually requires ventilator support. As an alternative to mechanical ventilation, stimulation of the phrenic nerve with electrodes implanted in the diaphragm is gaining acceptance. There is a need, however, to improve diaphragm stimulation and to add abdominal and upper thorax intercostal muscle stimulation for improved respiration and cough. We will test a new electrode for these applications: the PermalocTM bipolar multi-contact (P-BMC) electrode (Synapse Biomedical Inc). Respiratory responses with the new electrode will also be enhanced by using a high current respiratory stimulator and a biphasic stimulating wave form. One group of 12 acute dogs will be studied during this 1-YR investigation. Respiratory pacing studies following anesthesia will be conducted during periods of respiratory apnea following hyperventilation. Protocols will follow the order of the Aims of the study in each animal. Tracheal pressure will be the primary measure whereas airway flow will also be a primary measure. For cough and 20 min pacing tests airflow will be the primary measure. Additional respiratory measures will include esophageal and abdominal pressures. The recording of pneumobelts will provide a qualitative measure of upper-chest and abdominal muscle expansion and contractions to be recorded during airflow studies. Muscle contractile responses to stimulation will also be rated based on observation and palpation. Stimulation testing methods will include duplicate tests with random order assignment. All data will be presented as Mean + SEM. Statistical analysis will be done by ANOVA with post hoc comparisons made using the Student-Neuman-Keuls test. Results of this study are expected to contribute to technology transfer of the new electrode for cervical-level SCI patients. PUBLIC HEALTH RELEVANCE: Respiratory problems continue to be a primary concern for individuals with upper-level cervical spinal cord injury (SCI) with mortality most often attributed to pneumonia and usually requires ventilator support. As an alternative to mechanical ventilation, stimulation of the phrenic nerve with electrodes implanted in the diaphragm is gaining acceptance. There is a need, however, to improve diaphragm stimulation and to add abdominal and upper thorax intercostal muscle stimulation for improved respiration and cough. We will test a new electrode for these applications, the PermalocTM bipolar multi-contact (P-BMC; Synapse Biomedical Inc) in an animal model. Respiratory responses with the P-BMC will also be enhanced by using a high current respiratory stimulator and a biphasic stimulating wave form. Results of this study are expected to contribute to technology transfer of the new electrode for cervical-level SCI patient's respiratory care including Veterans Administration SCI patients.

描述（由申请人提供）： 完全性颈脊髓损伤（SCI）通常需要呼吸机支持。作为机械通气的替代方案，用植入隔膜中的电极刺激膈神经正在获得接受。 然而，需要改善膈肌刺激并增加腹部和上胸部肋间肌肉刺激以改善呼吸和咳嗽。我们将针对这些应用测试一种新电极：PermalocTM双极多触点（P-BMC）电极（Synapse Biomedical Inc）。 使用高电流呼吸刺激器和双相刺激波形也将增强新电极的呼吸反应。 在1年研究期间，将对一组12只急性试验犬进行研究。呼吸起搏研究 在过度通气后呼吸暂停期间进行麻醉。 方案将遵循每只动物的研究目的顺序。气管压力将是主要测量指标，而气道流量也将是主要测量指标。对于咳嗽和20分钟起搏测试，气流将是主要指标。其他呼吸措施将包括食管和腹部压力。 呼吸带的记录将提供气流研究期间记录的上胸部和腹部肌肉扩张和收缩的定性测量。还将根据观察和触诊评定肌肉对刺激的收缩反应。刺激测试方法将包括随机顺序分配的重复测试。所有数据将以平均值+ SEM表示。将通过ANOVA进行统计分析，并使用Student-Neuman-Keuls检验进行事后比较。本研究的结果预计将有助于颈部SCI患者的新电极的技术转让。 公共卫生关系： 呼吸问题仍然是高位颈髓损伤（SCI）患者的主要问题，死亡率最常归因于肺炎，通常需要呼吸机支持。作为机械通气的替代方案，用植入隔膜中的电极刺激膈神经正在获得接受。然而，需要改善膈肌刺激并增加腹部和上胸部肋间肌肉刺激以改善呼吸和咳嗽。我们将在动物模型中测试用于这些应用的新电极，PermalocTM双极多触点（P-BMC; Synapse Biomedical Inc）。还将通过使用高电流呼吸刺激器和双相刺激波形来增强P-BMC的呼吸反应。这项研究的结果有望有助于颈部SCI患者的新电极的技术转让 呼吸护理，包括退伍军人管理局SCI患者。