Co-activation of the diaphragm and external intercostal muscles through an adaptive closed-loop respiratory pacing controller

Introduction Respiratory pacing is a promising alternative to traditional mechanical ventilation that has been shown significantly increase the survival and quality of life after neural control respiratory system compromised. However, current approaches achieve adequate tend target only diaphragm without external intercostal muscles are also activated during normal inspiration. Furthermore, paradigms do not allow for intermittent sighing, which carries an important physiological role. We hypothesized simultaneous activation would improve efficiency compared stimulation alone. Materials Methods expanded adaptive, closed-loop paradigm we had previously developed include muscle sigh generation. then investigated, using rodent model pacing, if delay fatigability induction appropriate sigh-like behavior in spontaneously breathing un-injured anesthetized rats ( n = 8) with electrodes implanted bilaterally muscles, between 2nd 3rd spaces. Results With this novel system, show was lower when combined than alone p 0.014) able induce sighs higher tidal volumes 0.014). Conclusion Our findings demonstrate inspiratory could be used as suitable strategy stimulation-induced diaphragmatic fatigue health.