TY - JOUR T1 - Temporary transvenous diaphragmatic neurostimulatiom distributes tidal volume in a more physiological pattern versus mechanical ventilation alone. JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.RFMVC-2020.17 VL - 6 IS - suppl 4 SP - 17 AU - Elizabeth Rohrs AU - Thiago Bassi AU - Karl Fernandez AU - Marlena Ornowska AU - Michelle Nicholas AU - Steven Reynolds Y1 - 2020/02/13 UR - http://openres.ersjournals.com/content/6/suppl_4/17.abstract N2 - Mechanical ventilation in sedated patients overinflates caudal alveoli and underinflates rostral alveoli, causing volutrauma and atelectrauma thus resulting in ventilator induced lung injury. Temporary transvenous diaphragmatic neurostimulatiom (TTDN) stimulates diaphragm contraction. When used in synchrony with ventilation, TTDN yields a more normal physiological breathing pattern by promoting homogenous distribution of ventilation, improving gas exchange and reducing injury. A pilot study was conducted using 50 kg pigs ventilated in a mock ICU. Lung-protective volume control ventilation at 8 ml/kg was provided under deep sedation. TTDN therapy was delivered in synchrony with inspiration on every second breath to reduce the ventilator pressure-time-product by 15-20% for the TTDN+MV group.  This was compared to a mechanical ventilation only group (MV) and a never ventilated, spontaneous breathing group (NV). Alveolar chord length, estimating the mean free distance between gas exchange surfaces, was measured from histology samples for each group.TTDN therapy used as an adjunct to ventilation yields a more physiological pattern of alveoli expansion. This translates into less overdistension in the ventral areas and less atelectrauma in the dorsal areas and reduces lung injury. This technology has the potential to provide a novel method of lung-protective ventilation.FootnotesCite this article as: ERJ Open Research 2020; 6: Suppl. 4, 17.This is an ERS Respiratory Failure and Mechanical Ventilation Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -