Phrenic Identification in the ICU

Unity Health Toronto

Status: Not yet enrolling

Conditions: Neck Anatomy; Ventilator Lung; Diaphragm Disease; Phrenic Nerve; Ventilator-Induced Lung Injury; Phrenic Nerve Stimulation; Ultrasound

Treatments: Procedure: Neck ultrasound

Study type: Observational

Funder types: Other

Identifiers

NCT05875883

23-083

Details and patient eligibility

About

This will be a prospective observational study where the investigator will scan patients' necks with an ultrasound and look for anatomical landmarks that may help identify the phrenic nerve.

Full description

Patients under protective mechanical ventilation, an intervention that saves lives, may need sedation and paralyzing agents. However, sedation and paralyzing agents are associated with multiple complications, including diaphragm dysfunction.

Several strategies have been proposed to reduce diaphram dysfunction. A novel approach is to stimulate the phrenic nerve, either transvenously or transcutaneously. Transvenous stimulation requires a catheter, which eventually is associated with increased risk of infection and thrombosis. In this scenario, transcutaneous phrenic nerve pacing is attractive but may be more susceptible to patients' anthropometric measures.

The correlation between patients' anthropometric measures and the location of the phrenic has been poorly studied.

Enrollment: 63 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

• Age ≥ 18 years
• Admitted to ICU

Exclusion Criteria

• Patients with a cervical spine collar
• Patients who refuse to participate in the study