Systems and related methods for optimization of multi-electrode nerve pacing

A method for determining a recruitment relationship, the method comprising:

• inserting a plurality of electrodes into a patient, wherein the plurality of electrodes include an electrode combination;
• using the electrode combination, delivering a plurality of stimulation pulses intended to activate at least one respiratory muscle, wherein each stimulation pulse includes a corresponding charge, and the corresponding charges differ among the plurality of stimulation pulses;
• determining a recruitment relationship relating the corresponding charges to respiratory muscle responses resulting from the corresponding charges, wherein the recruitment relationship also relates undelivered charges to respiratory muscle responses expected from the undelivered charges;
• and
• after determining the recruitment relationship:
• a) stimulating the at least one respiratory muscle with the electrode combination,
• b) using the recruitment relationship, determining an expected respiratory muscle response to the stimulation, and
• c) comparing an actual respiratory muscle response to the expected respiratory muscle response.

A method for determining a recruitment relationship, the method comprising:

• assisting a plurality of breaths of a patient with a ventilator;
• inserting a plurality of electrodes into a patient, wherein the plurality of electrodes include an electrode combination;
• emitting a plurality of stimulation pulses from the electrode combination;
• measuring responses of at least one respiratory muscle to the plurality of stimulation pulses;
• based on the measured respiratory muscle responses, determining a first range of charges that includes a nerve activation threshold and a second range of charges within a proportional recruitment section;
• developing the recruitment relationship based on at least the first and second ranges of charges, wherein the recruitment relationship defines a relationship between a charge of a stimulation pulse and a respiratory muscle response;
• and
• after developing the recruitment relationship:
• a) stimulating the at least one respiratory muscle with the electrode combination,
• b) using the recruitment relationship, determining an expected respiratory muscle response to the stimulation, and
• c) comparing an actual respiratory muscle response to the expected respiratory muscle response.