biostudies-literatureUnknown4(12)Bassi TGIn a porcine healthy lung model, temporary transvenous diaphragm neurostimulation (TTDN) for 50 hours mitigated hippocampal apoptosis and inflammation associated with mechanical ventilation (MV).<h4>Hypothesis</h4>Explore whether TTDN in combination with MV for 12 hours mitigates hippocampal apoptosis and inflammation in an acute respiratory distress syndrome (ARDS) preclinical model.<h4>Methods and models</h4>Compare hippocampal apoptosis, inflammatory markers, and serum markers of neurologic injury between never ventilated subjects and three groups of mechanically ventilated subjects with injured lungs: MV only (LI-MV), MV plus TTDN every other breath, and MV plus TTDN every breath. MV settings in volume control were tidal volume 8 mL/kg and positive end-expiratory pressure 5 cm H₂O. Lung injury, equivalent to moderate ARDS, was achieved by infusing oleic acid into the pulmonary artery.<h4>Results</h4>Hippocampal apoptosis, microglia, and reactive-astrocyte percentages were similar between the TTDN-every-breath and never ventilated groups. The LI-MV group had a higher percentage of these measures than all other groups (<i>p</i> < 0.05). Transpulmonary driving pressure at study end was lower in the TTDN-every-breath group than in the LI-MV group; systemic inflammation and lung injury scores were not significantly different. The TTDN-every-breath group had considerably lower serum concentration of homovanillic acid (cerebral dopamine production surrogate) at study end than the LI-MV group (<i>p</i> < 0.05). Heart rate variability declined in the LI-MV group and increased in both TTDN groups (<i>p</i> < 0.05).<h4>Interpretations and conclusions</h4>In a moderate-ARDS porcine model, MV is associated with hippocampal apoptosis and inflammation, and TTDN mitigates that hippocampal apoptosis and inflammation.Critical care explorationse0820https://www.ebi.ac.uk/biostudies/studies/S-EPMC9788975biostudies-literatureDiaphragm Neurostimulation Mitigates Ventilation-Associated Brain Injury in a Preclinical Acute Respiratory Distress Syndrome Model.PMC9788975Bassi TGRohrs ECGani MMReynolds SCWittmann MJNicholas MMFernandez MKCEvans MDOrnowska MMfalseDiaphragm Neurostimulation Mitigates Ventilation-Associated Brain Injury in a Preclinical Acute Respiratory Distress Syndrome Model.In a porcine healthy lung model, temporary transvenous diaphragm neurostimulation (TTDN) for 50 hours mitigated hippocampal apoptosis and inflammation associated with mechanical ventilation (MV).<h4>Hypothesis</h4>Explore whether TTDN in combination with MV for 12 hours mitigates hippocampal apoptosis and inflammation in an acute respiratory distress syndrome (ARDS) preclinical model.<h4>Methods and models</h4>Compare hippocampal apoptosis, inflammatory markers, and serum markers of neurologic injury between never ventilated subjects and three groups of mechanically ventilated subjects with injured lungs: MV only (LI-MV), MV plus TTDN every other breath, and MV plus TTDN every breath. MV settings in volume control were tidal volume 8 mL/kg and positive end-expiratory pressure 5 cm H₂O. Lung injury, equivalent to moderate ARDS, was achieved by infusing oleic acid into the pulmonary artery.<h4>Results</h4>Hippocampal apoptosis, microglia, and reactive-astrocyte percentages were similar between the TTDN-every-breath and never ventilated groups. The LI-MV group had a higher percentage of these measures than all other groups (<i>p</i> < 0.05). Transpulmonary driving pressure at study end was lower in the TTDN-every-breath group than in the LI-MV group; systemic inflammation and lung injury scores were not significantly different. The TTDN-every-breath group had considerably lower serum concentration of homovanillic acid (cerebral dopamine production surrogate) at study end than the LI-MV group (<i>p</i> < 0.05). Heart rate variability declined in the LI-MV group and increased in both TTDN groups (<i>p</i> < 0.05).<h4>Interpretations and conclusions</h4>In a moderate-ARDS porcine model, MV is associated with hippocampal apoptosis and inflammation, and TTDN mitigates that hippocampal apoptosis and inflammation.2022-01-01T00:00:00Z2022 Dec2025-04-04T21:04:33.34Z2025-04-04T21:04:33.34ZS-EPMC97889753660156510.1097/CCE.0000000000000820