Ventilatory Support of the Quadriplegic Patient with Respiratory Paralysis by Diaphragm Pacing

Glenn, William W. L.; Hogan, James; Phelps, Mildred L.

doi:10.1016/s0039-6109(16)42233-4

Cited by 112 publications

(54 citation statements)

References 8 publications

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“…The second intercostal space is the most commonly used surgical approach for thoracic placement (11,14). Electrodes are often placed on each phrenic nerve during a single procedure.…”

Section: Equipment and Methods Of Applicationmentioning

confidence: 99%

“…They developed an implantable electrode/receiver system (6)(7)(8) that could be activated by radiofrequency waves generated by a power source external to the body. These investigators also accumulated a significant clinical experience that defined patient evaluation methods, surgical techniques, and safe parameters of stimulation that resulted in optimal diaphragm conditioning (9)(10)(11)(12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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Inspiratory Muscle Pacing in Spinal Cord Injury: Case Report and Clinical Commentary

DiMarco

Onders

Ignagni

et al. 2006

The Journal of Spinal Cord Medicine

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Background/Objective: A significant fraction of patients with cervical spinal cord injury suffer from respiratory muscle paralysis and dependence on chronic mechanical ventilation. In selected patients, diaphragm pacing (DP) through electrical stimulation of the phrenic nerves provides an alternative to mechanical ventilation with significant advantages in life quality.Methods: A case report of an individual who successfully underwent DP using intramuscular diaphragm electrodes. A brief review of the state of the art of DP including the clinical benefits of DP, patient selection and evaluation, description of equipment, methods of transition from mechanical ventilation to DP, potential complications and side effects, long-term outcome, and potential future developments in this field is included.Results: Several available DP systems are available, including conventional ones in which electrodes are positioned directly on the phrenic nerves through thoracotomy and less invasive systems in which electrodes are placed within the diaphragm through laparoscopy. For patients with only unilateral phrenic nerve function, a combined intercostal and unilateral diaphragm pacing system is under development. Conclusions:In patients with ventilator-dependent tetraplegia, there are alternative methods of ventilatory support, which offer substantial benefits compared to mechanical ventilation. Med. 2006;29:95-108 J Spinal Cord

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“…The second intercostal space is the most commonly used surgical approach for thoracic placement (11,14). Electrodes are often placed on each phrenic nerve during a single procedure.…”

Section: Equipment and Methods Of Applicationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inspiratory Muscle Pacing in Spinal Cord Injury: Case Report and Clinical Commentary

DiMarco

Onders

Ignagni

et al. 2006

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

show abstract

“…Animal results produced inspired volumes that were essentially identical to those resulting from direct phrenic nerve stimulation. [10][11][12][13] Onders' studies since the 1990s led to the current technology involving implantation of diaphragm electrodes via endoscopic surgery.…”

Section: Historymentioning

confidence: 99%

“…31 Atrotech (Tampere, Finland) and Medimplant (Vienna, Austria) systems differ from the Avery system in the electrode technology. 11,20,33,34 The Atrotech system has the ability to stimulate different portions of the nerve each time with the intention of reducing muscle fatigue. The Vienna phrenic pacer (Medimplant, Vienna, Austria) system also has multiple electrode contacts with the phrenic nerve.…”

Section: Phrenic Nerve Pacing Systemsmentioning

confidence: 99%

Functional Electrical Stimulation in Spinal Cord Injury Respiratory Care

Jarosz

Littlepage

Creasey

et al. 2012

Topics in Spinal Cord Injury Rehabilitation

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The management of chronic respiratory insufficiency and/or long-term inability to breathe independently has traditionally been via positive-pressure ventilation through a mechanical ventilator. Although life-sustaining, it is associated with limitations of function, lack of independence, decreased quality of life, sleep disturbance, and increased risk for infections. In addition, its mechanical and electronic complexity requires full understanding of the possible malfunctions by patients and caregivers. Ventilator-associated pneumonia, tracheal injury, and equipment malfunction account for common complications of prolonged ventilation, and respiratory infections are the most common cause of death in spinal cord-injured patients. The development of functional electric stimulation (FES) as an alternative to mechanical ventilation has been motivated by a goal to improve the quality of life of affected individuals. In this article, we will review the physiology, types, characteristics, risks and benefits, surgical techniques, and complications of the 2 commercially available FES strategies -phrenic nerve pacing (PNP) and diaphragm motor point pacing (DMPP).

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“…respiratory muscles.4 5 Patients with central alveolar hypoventilation were selected on the basis of several criteria, including the presence of clinical features of chronic hypoventilation and reduced ventilatory response to hypoxia and hypercapnia but near-normal results of tests of ventilatory capacity. There was clinical evidence of improvement in right heart failure after pacing was started and a fall in packed cell volume and pulmonary artery pressure.…”

mentioning

confidence: 99%

Severe metabolic alkalosis: a case report.

1981

BMJ

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Ventilatory Support of the Quadriplegic Patient with Respiratory Paralysis by Diaphragm Pacing

Cited by 112 publications

References 8 publications

Inspiratory Muscle Pacing in Spinal Cord Injury: Case Report and Clinical Commentary

Inspiratory Muscle Pacing in Spinal Cord Injury: Case Report and Clinical Commentary

Functional Electrical Stimulation in Spinal Cord Injury Respiratory Care

Severe metabolic alkalosis: a case report.

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