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Noninvasive Neuromodulation Techniques in Difficult Tracheostomy Weaning of Patients With Spinal Cord Injury
- Source :
- Chest. 159:e299-e302
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- High spinal cord injured patients (SCI) are susceptible to respiratory muscle impairments. Transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) may influence the diaphragm's central control, but until now they are not described as a therapeutic resource for difficult weaning. We present two case reports of SCI patients (P1 and P2) with long-term tracheostomy (>40 days) and hospital stay (>50 days). In association with respiratory exercise, P1 received a combined application of anodal tDCS over the supplementary motor area plus sensory PES in the thoracic-abdominal muscles, and P2 received isolated excitatory PES in the abdominal muscles, applied daily except on weekends. Maximum inspiratory/expiratory pressure, peak cough flow, diaphragm excursion, and thickening fraction were measured in the first and last days of the protocol. Both patients had improvements, with clinical impact such as cough effectiveness, decannulated after 15 applications of stimulation. Augmentation of neural respiratory drive and corticospinal excitability is suggested.
- Subjects :
- Pulmonary and Respiratory Medicine
Transcranial direct-current stimulation
Supplementary motor area
business.industry
medicine.medical_treatment
Critical Care and Intensive Care Medicine
medicine.disease
Spinal cord
Neuromodulation (medicine)
Diaphragm (structural system)
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
030228 respiratory system
Anesthesia
medicine
Respiratory muscle
030212 general & internal medicine
Respiratory system
Cardiology and Cardiovascular Medicine
business
Spinal cord injury
Subjects
Details
- ISSN :
- 00123692
- Volume :
- 159
- Database :
- OpenAIRE
- Journal :
- Chest
- Accession number :
- edsair.doi...........6aa2332cc01862144dbe191f0fbbb1d8