PMID- 22506946
OWN - NLM
STAT- MEDLINE
DCOM- 20120813
LR  - 20151119
IS  - 1553-2712 (Electronic)
IS  - 1069-6563 (Linking)
VI  - 19
IP  - 4
DP  - 2012 Apr
TI  - Feasibility of percutaneous vagus nerve stimulation for the treatment of acute 
      asthma exacerbations.
PG  - 421-9
LID - 10.1111/j.1553-2712.2012.01329.x [doi]
AB  - OBJECTIVES: This study assessed the feasibility of an investigational vagus nerve 
      stimulation (VNS) device for treating acute asthma exacerbations in patients not 
      responding to at least 1 hour of initial standard care therapy. METHODS: This was 
      a prospective, nonrandomized study of patients treated in the ED for moderate to 
      severe acute asthma (forced expiratory volume in 1 second [FEV(1)] 25% to 70% of 
      predicted). Treatment entailed percutaneous placement of an electrode near the 
      right carotid sheath and 60 minutes of VNS and continued standard care. VNS 
      voltage was adjusted to perceived improvement, muscle twitching, or adverse 
      events (AEs). All AEs, vital signs, FEV(1), perceived work of breathing (WOB), 
      and final disposition were recorded. RESULTS: Twenty-five subjects were enrolled. 
      There were no serious AEs and no significant changes in vital signs. No subject 
      required terminating VNS. One patient had minor bleeding from the procedure, and 
      one had a hematoma and withdrew prior to VNS. AEs related to VNS were temporary 
      and included cough (1 of 24), swallowing difficulty (2 of 24), voice change (2 of 
      24), and muscle twitching (14 of 24). These resolved when VNS ended. The FEV(1) 
      improved at 15 minutes (median = 15.8%, 95% confidence interval [CI] = 9.3% to 
      22.4%), 30 minutes (median = 21.3%, 95% CI = 8.1% to 36.5%), and 60 minutes 
      (median = 27.5%, 95% CI = 11.3% to 43.5%). WOB improved at 15 minutes (median = 
      53.9%, 95% CI = 33.7% to 73.9%), 30 minutes (median = 69.1%, 95% CI = 56.4% to 
      81.8%), and 60 minutes (median = 81.0%, 95% CI = 68.5% to 93.5%). CONCLUSIONS: 
      Percutaneous VNS did not result in serious AEs and was associated with 
      improvements in FEV(1) and perceived dyspnea. Percutaneous VNS appears to be 
      feasible for use in the treatment of moderate to severe acute asthma in patients 
      unresponsive to initial standard care treatment.
CI  - (c) 2012 by the Society for Academic Emergency Medicine.
FAU - Miner, James R
AU  - Miner JR
AD  - Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, 
      MN, USA. miner015@umn.edu
FAU - Lewis, Lawrence M
AU  - Lewis LM
FAU - Mosnaim, Giselle S
AU  - Mosnaim GS
FAU - Varon, Joseph
AU  - Varon J
FAU - Theodoro, Daniel
AU  - Theodoro D
FAU - Hoffmann, Thomas J
AU  - Hoffmann TJ
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Acad Emerg Med
JT  - Academic emergency medicine : official journal of the Society for Academic 
      Emergency Medicine
JID - 9418450
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - Asthma/*therapy
MH  - *Emergency Service, Hospital
MH  - Feasibility Studies
MH  - Female
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Spirometry
MH  - Treatment Outcome
MH  - Vagus Nerve Stimulation/*methods
MH  - Vital Signs
MH  - Work of Breathing
EDAT- 2012/04/18 06:00
MHDA- 2012/08/14 06:00
CRDT- 2012/04/18 06:00
PHST- 2012/04/18 06:00 [entrez]
PHST- 2012/04/18 06:00 [pubmed]
PHST- 2012/08/14 06:00 [medline]
AID - 10.1111/j.1553-2712.2012.01329.x [doi]
PST - ppublish
SO  - Acad Emerg Med. 2012 Apr;19(4):421-9. doi: 10.1111/j.1553-2712.2012.01329.x.