Authors : William Charles Pereira; Pandavadra Roshani Ranmalbhai; Jenisha Dsouza

Volume/Issue : Volume 11 - 2026, Issue 5 - May

Google Scholar : https://tinyurl.com/4p79xn98

Scribd : https://tinyurl.com/y2zkycuw

DOI : https://doi.org/10.38124/ijisrt/26May826

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Background and Need: Mechanical ventilator (MV) is a life-saving technology that assist or restores breathing. Prolonged mechanical ventilator has its own side effects, like promoting ventilator induced diaphragm dysfunction, diaphragmatic atrophy and even weaning difficulty. Stimulation of the phrenic nerve can play an important role in diaphragm contraction which can have a potential to prevent and treat diaphragm atrophy. This article aims to give an overview of phrenic nerve stimulation to improve diaphragm contraction in ventilator induced diaphragm dysfunction.  Methods: 788 articles were retrieved from databases viz. PubMed, Science Direct and Google Scholar. Considering the inclusion and exclusion criteria, five studies were found eligible for this review that consisted of interventional and cohort studies.  Results: Two randomised controlled trials found significant improvement in diaphragm contraction that led to the weaning of the patient from the ventilator. Alternately, one clinical study two nonrandomised trials and one prospective cohort study showed lower the twitch pressure and thickness fraction can lead to failure.  Conclusion: Phrenic nerve stimulation can be a promising avenue for the treatment of ventilator induced diaphragm dysfunction and diaphragm atrophy by improving the diaphragm contraction, which causes liberation from the mechanical ventilator.

Keywords : Muscle Atrophy, Muscle Paresis, Lung Injuries, Ventilator Induced, VIDD, Ventilator-Induced Lung Injury.

References :

1. Zhang J et al. Research progress on the pathogenesis and treatment of ventilator-induced diaphragm dysfunction. Heliyon. 2023 Nov.
2. Soták M, Roubík K, Henlín T, Tyll T. Phrenic nerve stimulation prevents diaphragm atrophy in patients with respiratory failure on mechanical ventilation. BMC pulmonary medicine. 2021 Dec:1-8.
3. Evans D et al. Temporary transvenous diaphragm pacing vs. standard of care for weaning from mechanical ventilation: study protocol for a randomized trial. Trials. 2019 Dec; 20:1-3.
4. Panelli A, Verfuß MA, Dres M, Brochard L, Schaller SJ. Phrenic nerve stimulation to prevent diaphragmatic dysfunction and ventilator-induced lung injury. Intensive Care Medicine Experimental. 2023 Dec ;11(1):94.
5. Peñuelas O, et al. Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill. Intensive care medicine experimental. 2019 Jul;7(Suppl 1):48.
6. Etienne H et al. Diaphragm neurostimulation assisted ventilation in critically ill patients. American journal of respiratory and critical care medicine. 2023 May;207(10):1275-82.
7. Cawley MJ. Mechanical ventilation: introduction for the pharmacy practitioner. Journal of Pharmacy Practice. 2011 Feb;24(1):7-16.
8. Standring S. Gray’s Anatomy 41 st Ed: The Anatomical Basis of Clinical Practice. Churchill Livingstone, Edinburgh, London. 2016.
9. Khanday S. Anatomical variations in the human body: exploring the boundaries of normality (Doctoral dissertation, Kingston University).
10. Moore KL, Dalley AF, Agur MR. Clinically oriented anatomy. 7. izdanje.
11. Kaufmann EM, Krause S, Geisshuesler L, Scheidegger O, Haeberlin A, Niederhauser T. Feasibility of transesophageal phrenic nerve stimulation. Biomedical engineering online. 2023 Jan;22(1):5.
12. Keogh C, et al. Non‐invasive phrenic nerve stimulation to avoid ventilator‐induced diaphragm dysfunction in critical care. Artificial Organs. 2022 Oct;46(10):1988-97.
13. Bose R, Banerjee AD, Brajesh V, Narang KS, Dubey S, Singh VP. Phrenic nerve stimulation for diaphragmatic pacing in chronic ventilator-dependent patients. Neurology India. 2018 Nov;66(6):1834-7.
14. Dres M et al. Randomized clinical study of temporary transvenous phrenic nerve stimulation in difficultto-wean patients. American Journal of Respiratory and Critical Care Medicine. 2022 May ;205(10):1169-78.
15. WEESE‐MAYER DE et al. Diaphragm pacing with a quadripolar phrenic nerve electrode: an international study. Pacing and clinical electrophysiology. 1996 Sep(9):1311-9.