Abstract

Mechanical ventilation can lead to diaphragm atrophy and lung damage, which may be attenuated by inducing diaphragm activation via rapid bilateral anterior magnetic phrenic nerve stimulation (rBAMPS). However, the reliability of inspiratory responses to rBAMPS remains unknown. Thus, 8 healthy participants (23±6y; 3f) underwent 5 blocks (B1-5) of 3 1-s rBAMPS at 25Hz and 20% (+10% increments) of max. stimulator output with the glottis open across 3 separate days. Tidal volume (VT), transdiaphragmatic pressure (Pdi) and discomfort (0-10points) were recorded for each rBAMPS. Averages of 3 rBAMPS were compared within-day (B1-3) and between-days (B1,4,5) by calculating interclass correlation coefficients (ICC) and standard error of measurements (SEM) for VT and mean Pdi at the lowest stimulator output that produced an inspiration (29±6%). Individual VT differed by 0.14±0.11L within-day and had ?good? reliability (B1=0.50±0.24, B2=0.43±0.20, B3=0.41±0.16L; ICC=0.78; SEM=0.14). Mean Pdi was 4.9±2.0 (B1), 4.3±2.9 (B2) and 4.0±2.1cmH2O (B3) during these rBAMPS with ?good? reliability (ICC=0.75, SEM=1.6). Between-day reliability of VT was ?moderate? (B1=0.50±0.24, B4=0.39±0.29, B5=0.41±0.28L; ICC=0.70; SEM=0.20) with a larger average difference between blocks (0.23±0.14L). Corresponding mean Pdi had ?good? reliability (B1=4.9±2.0, B4=3.7±2.6, B5=4.3±3.1cmH2O; ICC=0.79; SEM=1.7). Discomfort did not differ within- (B1=0.8±0.1, B2=0.6±0.9, B3=0.4±0.7points) and between-days (B1=0.8±0.1, B4=0.5±0.8, B5=0.3±0.7points; all P>0.05). VT in response to rBAMPS is more reliable within- than between-days, while Pdi is similarily reliable. Discomfort from rBAMPS does not change over time.