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使用表面电极刺激腹部和上胸部肌肉以辅助呼吸和咳嗽:成年犬的急性研究

Stimulation of abdominal and upper thoracic muscles with surface electrodes for respiration and cough: Acute studies in adult canines.

作者信息

Walter James S, Posluszny Joseph, Dieter Raymond, Dieter Robert S, Sayers Scott, Iamsakul Kiratipath, Staunton Christine, Thomas Donald, Rabbat Mark, Singh Sanjay

机构信息

a Research Services, Edward Hines Jr. VA Hospital , Hines , Illinois , USA.

d Urology Departments , Loyola University, Stritch School of Medicine , Maywood , Illinois , USA.

出版信息

J Spinal Cord Med. 2018 May;41(3):326-336. doi: 10.1080/10790268.2017.1335447. Epub 2017 Jun 14.

Abstract

OBJECTIVE

To optimize maximal respiratory responses with surface stimulation over abdominal and upper thorax muscles and using a 12-Channel Neuroprosthetic Platform.

METHODS

Following instrumentation, six anesthetized adult canines were hyperventilated sufficiently to produce respiratory apnea. Six abdominal tests optimized electrode arrangements and stimulation parameters using bipolar sets of 4.5 cm square electrodes. Tests in the upper thorax optimized electrode locations, and forelimb moment was limited to slight-to-moderate. During combined muscle stimulation tests, the upper thoracic was followed immediately by abdominal stimulation. Finally, a model of glottal closure for cough was conducted with the goal of increased peak expiratory flow.

RESULTS

Optimized stimulation of abdominal muscles included three sets of bilateral surface electrodes located 4.5 cm dorsal to the lateral line and from the 8 intercostal space to caudal to the 13 rib, 80 or 100 mA current, and 50 Hz stimulation frequency. The maximal expired volume was 343 ± 23 ml (n=3). Optimized upper thorax stimulation included a single bilateral set of electrodes located over the 2 interspace, 60 to 80 mA, and 50 Hz. The maximal inspired volume was 304 ± 54 ml (n=4). Sequential stimulation of the two muscles increased the volume to 600 ± 152 ml (n=2), and the glottal closure maneuver increased the flow.

CONCLUSIONS

Studies in an adult canine model identified optimal surface stimulation methods for upper thorax and abdominal muscles to induce sufficient volumes for ventilation and cough. Further study with this neuroprosthetic platform is warranted.

摘要

目的

使用12通道神经假体平台,通过对腹部和上胸部肌肉进行表面刺激来优化最大呼吸反应。

方法

在安装仪器后,对六只麻醉的成年犬进行充分的过度通气以产生呼吸暂停。六项腹部测试使用4.5平方厘米的方形双极电极组优化电极排列和刺激参数。上胸部测试优化电极位置,前肢力矩限制在轻度至中度。在联合肌肉刺激测试中,上胸部刺激后立即进行腹部刺激。最后,以增加呼气峰值流量为目标进行了声门关闭咳嗽模型实验。

结果

优化的腹部肌肉刺激包括三组双侧表面电极,位于侧线背侧4.5厘米处,从第8肋间间隙到第13肋尾端,电流为80或100毫安,刺激频率为50赫兹。最大呼气量为343±23毫升(n=3)。优化的上胸部刺激包括一组位于第2间隙上方的双侧电极,电流为60至80毫安,频率为50赫兹。最大吸气量为304±54毫升(n=4)。对两块肌肉进行顺序刺激可使气量增加到600±152毫升(n=2),声门关闭动作可增加流量。

结论

在成年犬模型中的研究确定了对上胸部和腹部肌肉进行最佳表面刺激的方法,以诱导足够的气量用于通气和咳嗽。有必要使用该神经假体平台进行进一步研究。

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本文引用的文献

1
High frequency spinal cord stimulation-New method to restore cough.高频脊髓刺激——恢复咳嗽的新方法。
Respir Physiol Neurobiol. 2016 Oct;232:54-6. doi: 10.1016/j.resp.2016.07.001. Epub 2016 Jul 6.
7
Functional electrical stimulation and spinal cord injury.功能性电刺激与脊髓损伤
Phys Med Rehabil Clin N Am. 2014 Aug;25(3):631-54, ix. doi: 10.1016/j.pmr.2014.05.001.
9
Activation of inspiratory muscles via spinal cord stimulation.经脊髓刺激激活吸气肌。
Respir Physiol Neurobiol. 2013 Nov 1;189(2):438-49. doi: 10.1016/j.resp.2013.06.001. Epub 2013 Jun 7.

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