Phrenic nerve pacing to improve outcome in mechanically ventilated patients with acute respiratory distress syndrome

Our lungs normally work by the diaphragm contracting and pulling air into our lungs. The mechanical ventilator is an amazing invention that blows air into the lungs to inflate them. However, research has shown that this can cause lung, diaphragm, and brain injury. Recently, the intravenous catheter that is used in almost all ICU patients has been modified to have the ability to send a directed pulse of electricity across the blood vessel wall to activate the nerve that travels from the brain to the diaphragm, called the phrenic nerve. By sending a carefully directed electrical pulse, the diaphragm can be activated even in patients who are deeply sedated and critically ill. We have shown in a pig model that when this is used in conjunction with mechanical ventilation, it can protect the lung, diaphragm, and brain from injury. We propose studying patients who have low-oxygen levels and are acutely ill. Our team at Royal Columbian Hospital has extensive experience with this novel intervention and will be partnering with a multi-disciplinary team, including patient partners, to carry out this patient-oriented research. This work has the potential to improve patient outcomes and save the healthcare system valuable resources.