North Shore University Hospital Device Accelerates Ventilator Weaning in Patients
A critically ill patient at Northwell Health’s North Shore University Hospital (NSUH) has become one of the first patients in the United States—and the first on the East Coast—to be successfully treated with Lungpacer Medical’s AeroPace system, an innovative neurostimulation-based therapy designed to help patients on mechanical ventilation regain independent breathing more quickly.
The milestone marks an early clinical adoption of a technology aimed at addressing one of the most challenging problems in intensive care medicine: ventilator dependency and the gradual weakening of respiratory muscles during prolonged mechanical support. The AeroPace device, which has received FDA approval, uses targeted neurostimulation to activate and strengthen the diaphragm, the primary muscle responsible for breathing. By engaging the body’s natural respiratory pathways, the system is designed to help patients transition off ventilators more efficiently and safely.
A New Approach to Weaning Patients from Mechanical Ventilation
Mechanical ventilation is a life-saving intervention used in intensive care units (ICUs) for patients who are unable to breathe adequately on their own due to severe illness, trauma, or respiratory failure. While essential, prolonged ventilation can lead to a condition known as ventilator-induced diaphragm dysfunction (VIDD), in which the diaphragm weakens due to disuse. As the ventilator assumes the full workload of breathing, the diaphragm receives little to no natural stimulation, resulting in rapid muscle atrophy.
This loss of muscle strength can make it increasingly difficult to wean patients off ventilatory support, extending ICU stays and increasing the risk of complications such as infections, delirium, and overall deconditioning.
Lungpacer Medical’s AeroPace system is designed to address this problem by actively stimulating the diaphragm during mechanical ventilation. According to the company, the device uses neurostimulation to engage the phrenic nerves, which control diaphragm movement, thereby helping maintain muscle activity even while a patient is still on a ventilator.
Clinical data cited by the company suggest that this approach may reduce the duration of mechanical ventilation by approximately 43%, particularly in patients who have been ventilated for more than 96 hours. In practical terms, this could translate into several days less on a ventilator, depending on patient condition and severity of illness.
First East Coast Clinical Use at North Shore University Hospital
North Shore University Hospital, a Level I trauma center and teaching hospital located in Manhasset, New York, is part of Northwell Health, the largest nonprofit health system in the northeastern United States. The hospital treats more than 90,000 patients annually and is frequently referred complex cases due to its advanced critical care capabilities.
The AeroPace system was introduced at NSUH under the leadership of Dr. Eric Gottesman, a critical care physician and director of intensivist medicine at the hospital. Dr. Gottesman and his team oversee some of the most medically complex ICU patients in the region, including individuals suffering from respiratory failure, multi-organ dysfunction, and post-surgical complications requiring prolonged ventilatory support.
Dr. Gottesman noted that the COVID-19 pandemic underscored the global challenge of ventilator dependency. During the early waves of the pandemic, ICUs worldwide were overwhelmed by patients requiring mechanical ventilation, many of whom experienced prolonged recovery periods or were unable to be successfully weaned.
He explained that the diaphragm plays a central role in breathing, accounting for more than 90% of the work involved in inhalation under normal physiological conditions. When a ventilator takes over this function, the diaphragm is largely inactive, which can lead to rapid weakening over time. The longer a patient remains on mechanical ventilation, the more difficult it can become to restore independent breathing.
According to Dr. Gottesman, technologies that maintain or restore diaphragm function during ventilation could have a meaningful impact on patient outcomes, particularly in reducing time to extubation and minimizing complications associated with extended ICU stays.
How the AeroPace System Works
The AeroPace device is a catheter-based system that delivers targeted electrical stimulation to the phrenic nerves, which are responsible for signaling the diaphragm to contract. The catheter is typically inserted via a central vein, such as the subclavian vein or internal jugular vein, and positioned to allow electrode-based stimulation of the nerves controlling respiratory muscle activity.
By activating the diaphragm even while a patient is on mechanical ventilation, the system aims to preserve muscle strength and prevent atrophy. This approach essentially allows the diaphragm to “exercise” during the period of ventilatory support, maintaining its functional capacity and improving readiness for spontaneous breathing once ventilator support is reduced.
Clinical studies referenced by the company indicate that patients treated with AeroPace may experience shorter durations of mechanical ventilation compared with standard care. In some analyses, the device has been associated with a reduction of approximately three days in ventilator time, depending on patient population and baseline risk factors.
Potential Benefits in Critical Care Settings
From a clinical perspective, reducing time on mechanical ventilation is an important goal in intensive care medicine. Prolonged ventilation is associated with increased risks of ventilator-associated pneumonia, muscle deconditioning, longer hospital stays, and higher healthcare costs. It can also delay rehabilitation and increase the likelihood of long-term functional impairment after discharge.
By supporting earlier weaning from ventilatory support, diaphragm-targeted neurostimulation may help mitigate some of these risks. In addition to improving clinical outcomes, shorter ICU stays can also reduce strain on critical care resources, particularly in high-volume hospital systems.
Dr. Eric Gottesman emphasized that while mechanical ventilation remains an essential and often life-saving intervention, optimizing the recovery process is equally important. He highlighted that innovations like AeroPace offer a new way to think about respiratory support—not only sustaining life during acute illness but also actively supporting recovery of natural physiological function.
Institutional Support and Clinical Integration
David Hirschwerk, MD, Chief Medical Officer at North Shore University Hospital, expressed support for the introduction of the AeroPace system into the hospital’s ICU programs. He noted that Northwell Health’s critical care teams are continuously evaluating new technologies that can improve patient outcomes and reduce the burden of prolonged hospitalization.
According to Dr. Hirschwerk, the primary objective of adopting technologies like AeroPace is to shorten the time patients spend on mechanical ventilation, which in turn can reduce overall hospital length of stay and improve recovery trajectories, particularly among critically ill and high-risk patients.
NSUH is part of Northwell Health, a major academic health system that includes 28 hospitals and more than 1,000 outpatient facilities across New York. The system encompasses a wide range of specialty centers, including the Sandra Atlas Bass Heart Hospital, the Katz Women’s Hospital, neurosurgical programs, multi-organ transplant services, and one of the busiest emergency departments in the New York metropolitan area.
Broader Implications for ICU Medicine
The introduction of neurostimulation-based diaphragm activation represents a broader shift in critical care toward preserving physiological function during life-support interventions. Rather than focusing solely on sustaining life through external systems, emerging technologies increasingly aim to maintain or simulate natural biological activity during treatment.
If validated across larger patient populations, approaches like AeroPace could become part of standard ICU protocols for managing patients requiring prolonged ventilation. This would represent a meaningful evolution in respiratory critical care, integrating neurophysiology and mechanical support to improve both survival and recovery outcomes.
The successful treatment of a critically ill patient at North Shore University Hospital using Lungpacer’s AeroPace system marks an early but significant step in the adoption of diaphragm-targeted neurostimulation therapy in the United States. By actively stimulating the respiratory muscles during mechanical ventilation, the technology aims to reduce muscle atrophy, shorten ventilator dependence, and improve overall recovery in critically ill patients.
As NSUH and other leading hospitals continue to evaluate and integrate such innovations, the approach may help redefine how clinicians manage respiratory failure—shifting from passive life support toward more active preservation of natural breathing function during critical illness.
About Northwell Health
Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, western Connecticut and beyond, thanks to philanthropic support from our communities.
Northwell is New York State’s largest private employer with over 106,000 employees – including members of Northwell Health Physician Partners and Nuvance Health Medical Practices – who are working to change health care for the better. Northwell, named a TIME100 Most Influential Companies 2025, is making breakthroughs in medicine at the Feinstein Institutes for Medical Research. Northwell is training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies.
