Bilateral phrenic nerve block as an effective means of controlling inspiratory efforts in a COVID-19 patient

Ryuichi Nakayama; Yusuke Iwamoto; Naofumi Bunya; Atsushi Sawada; Kazunobu Takahashi; Yuya Goto; Takehiko Kasai; Ryuichiro Kakizaki; Shuji Uemura; Eichi Narimatsu

doi:10.1016/j.rmcr.2021.101455

Bilateral phrenic nerve block as an effective means of controlling inspiratory efforts in a COVID-19 patient

Ryuichi Nakayama, Yusuke Iwamoto, Naofumi Bunya, Atsushi Sawada, Kazunobu Takahashi, Yuya Goto, Takehiko Kasai, Ryuichiro Kakizaki, Shuji Uemura, Eichi Narimatsu

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Bilateral continuous phrenic nerve block effectively regulates refractory persistent, strong inspiratory effort in a patient with coronavirus disease (COVID-19). A 73-year-old man with acute respiratory distress syndrome (ARDS) due to COVID-19 was admitted to the intensive care unit (ICU). Use of neuromuscular blocking agents (NMBAs) was stopped due to uncontrollable strong inspiratory efforts and worsened lung injury. We performed bilateral continuous phrenic nerve block, which suppressed inspiratory efforts, resulting in lung injury improvement. A bilateral continuous phrenic nerve block is a viable alternative to control refractory strong inspiratory effort leading to lung injury in cases with prolonged NMBA use.

Original language	English (US)
Article number	101455
Journal	Respiratory Medicine Case Reports
Volume	33
DOIs	https://doi.org/10.1016/j.rmcr.2021.101455
State	Published - Jan 2021
Externally published	Yes

Keywords

Acute respiratory distress syndrome
Case report
COVID-19
Neuromuscular blocking agents
Patient self-inflicted lung injury
Phrenic nerve block

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine

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10.1016/j.rmcr.2021.101455

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title = "Bilateral phrenic nerve block as an effective means of controlling inspiratory efforts in a COVID-19 patient",

abstract = "Bilateral continuous phrenic nerve block effectively regulates refractory persistent, strong inspiratory effort in a patient with coronavirus disease (COVID-19). A 73-year-old man with acute respiratory distress syndrome (ARDS) due to COVID-19 was admitted to the intensive care unit (ICU). Use of neuromuscular blocking agents (NMBAs) was stopped due to uncontrollable strong inspiratory efforts and worsened lung injury. We performed bilateral continuous phrenic nerve block, which suppressed inspiratory efforts, resulting in lung injury improvement. A bilateral continuous phrenic nerve block is a viable alternative to control refractory strong inspiratory effort leading to lung injury in cases with prolonged NMBA use.",

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language = "English (US)",

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journal = "Respiratory Medicine Case Reports",

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AU - Nakayama, Ryuichi

AU - Iwamoto, Yusuke

AU - Bunya, Naofumi

AU - Sawada, Atsushi

AU - Takahashi, Kazunobu

AU - Goto, Yuya

AU - Kasai, Takehiko

AU - Kakizaki, Ryuichiro

AU - Uemura, Shuji

AU - Narimatsu, Eichi

PY - 2021/1

Y1 - 2021/1

N2 - Bilateral continuous phrenic nerve block effectively regulates refractory persistent, strong inspiratory effort in a patient with coronavirus disease (COVID-19). A 73-year-old man with acute respiratory distress syndrome (ARDS) due to COVID-19 was admitted to the intensive care unit (ICU). Use of neuromuscular blocking agents (NMBAs) was stopped due to uncontrollable strong inspiratory efforts and worsened lung injury. We performed bilateral continuous phrenic nerve block, which suppressed inspiratory efforts, resulting in lung injury improvement. A bilateral continuous phrenic nerve block is a viable alternative to control refractory strong inspiratory effort leading to lung injury in cases with prolonged NMBA use.

AB - Bilateral continuous phrenic nerve block effectively regulates refractory persistent, strong inspiratory effort in a patient with coronavirus disease (COVID-19). A 73-year-old man with acute respiratory distress syndrome (ARDS) due to COVID-19 was admitted to the intensive care unit (ICU). Use of neuromuscular blocking agents (NMBAs) was stopped due to uncontrollable strong inspiratory efforts and worsened lung injury. We performed bilateral continuous phrenic nerve block, which suppressed inspiratory efforts, resulting in lung injury improvement. A bilateral continuous phrenic nerve block is a viable alternative to control refractory strong inspiratory effort leading to lung injury in cases with prolonged NMBA use.

KW - Acute respiratory distress syndrome

KW - Case report

KW - COVID-19

KW - Neuromuscular blocking agents

KW - Patient self-inflicted lung injury

KW - Phrenic nerve block

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Bilateral phrenic nerve block as an effective means of controlling inspiratory efforts in a COVID-19 patient

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

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