A versatile fast-development platform applied to closed-loop diaphragmatic pacing

People with cervical spinal cord injury have partial or complete loss of ventilatory control and require ventilator assist. Open-loop diaphragmatic pacing can be utilized to provide this assist. A closed-loop diaphragmatic pacing system could overcome the drawbacks for manual titration of the stimulation and respond to changing ventilatory requirements. We have developed a versatile custom hardware platform dubbed “Multimed” for biosignal acquisition and parallel real-time computation, data display and storage. We have also developed a new rodent model for diaphragmatic pacing. Using these we illustrate, to our knowledge for the first-time, the successful ability to perform respiratory flow-phase triggered closed-loop diaphragmatic stimulation with resultant changes in respiratory flow and tidal volume.

[1]  Brian K Hillen,et al.  Computational model of human ventilation for electrical stimulation following cervical spinal cord injury , 2014, BMC Neuroscience.

[2]  Alabama,et al.  Spinal Cord Injury Facts and Figures at a Glance , 2013, The journal of spinal cord medicine.

[3]  A. Dimarco,et al.  Restoration of respiratory muscle function following spinal cord injury Review of electrical and magnetic stimulation techniques , 2005, Respiratory Physiology & Neurobiology.

[4]  A. Quotb,et al.  Live demonstration: Real-time wavelet spike detection with in-vitro biological signals , 2012, 2012 IEEE Biomedical Circuits and Systems Conference (BioCAS).

[5]  W. Glenn,et al.  Twenty Years of Experience in Phrenic Nerve Stimulation to Pace the Diaphragm , 1986, Pacing and clinical electrophysiology : PACE.

[6]  R. Onders,et al.  Complete worldwide operative experience in laparoscopic diaphragm pacing: results and differences in spinal cord injured patients and amyotrophic lateral sclerosis patients , 2009, Surgical Endoscopy.

[7]  Spinal Cord Injury Facts and Figures at a Glance , 2014, The journal of spinal cord medicine.

[8]  D.E. Dow,et al.  EMG-Based Detection of Inspiration in the Rat Diaphragm Muscle , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[9]  Carlos B. Mantilla,et al.  Diaphragm motor unit recruitment in rats , 2010, Respiratory Physiology & Neurobiology.

[10]  James J. Abbas,et al.  Repetetive hindlimb movement using intermittent adaptive neuromuscular electrical stimulation in an incomplete spinal cord injury rodent model , 2010, Experimental Neurology.

[11]  Yannick Bornat,et al.  NeuroBetaMed: A re-configurable wavelet-based event detection circuit for in vitro biological signals , 2012, 2012 IEEE International Symposium on Circuits and Systems.

[12]  A. Dimarco Phrenic nerve stimulation in patients with spinal cord injury , 2009, Respiratory Physiology & Neurobiology.

[13]  R B Trelease,et al.  A new technique for acute and chronic recording of crural diaphragm EMG in cats. , 1982, Electroencephalography and clinical neurophysiology.

[14]  Robert L Chatburn,et al.  Closed-Loop Control of Mechanical Ventilation: Description and Classification of Targeting Schemes , 2011, Respiratory Care.