Respiratory failure & ventilation
Ultrasound-guided Transcutaneous Phrenic Nerve Stimulation in Critically Ill Patients: A New Method to Evaluate Diaphragmatic Function
Authors' conclusion
The SONOTEPS method is a simple and accurate tool for bedside assessment of diaphragm function with ultrasound-guided transcutaneous phrenic nerve stimulation in sedated patients with no or minimal spontaneous respiratory activity.
Study context
- Population
- Adult ICU patients under mechanical ventilation with RASS −4 or −5232 measures
- Participants
- 116 participants
- Comparison
- SONOTEPS vs Magnetic stimulation
- SONOTEPSn = 116
- Magnetic stimulationn = 116reference
- Primary endpoint
- Tracheal pressure induced by stimulation
Methodological detailsrandomized crossover
- Randomized crossover
Primary result
As reported in the abstract
Tracheal pressure induced by stimulation (SONOTEPS vs magnetic stimulation agreement)
Passing-Bablok intercept A
−0.03
95% CI −0.83 to 0.52
SONOTEPS
Passing-Bablok slope B
0.98
95% CI 0.90–1.05
SONOTEPS
- Positive correlation between methods (R²)
- 0.639
- Mean bias
- −1.08 (95% CI, 5.02 to −7.18) cm H 2 O (95% CI)
Further findings
Diagnostic performance for diaphragm dysfunction (tracheal pressure <11 cm H2O), AUC
- AUC (95% CI), excellent performance
- 0.90 (95% CI, 0.83 to 0.97)
Diagnostic performance for severe diaphragm dysfunction (tracheal pressure <8 cm H2O), AUC
- AUC (95% CI), excellent performance
- 0.88 (95% CI, 0.82 to 0.95)
Effect of BMI or neck catheter on diagnostic performance
- Performance not significantly affected by BMI or presence of a neck catheter
Original publication
Ultrasound-guided Transcutaneous Phrenic Nerve Stimulation in Critically Ill Patients: A New Method to Evaluate Diaphragmatic Function. Anesthesiology. Published 21 October 2024. doi:10.
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