Phrenic nerve stimulation for diaphragmatic pacing in a patient with high cervical spinal cord injury. 2009

Bunpot Sitthinamsuwan, and Sarun Nunta-aree
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. bunpotsi@yahoo.com

BACKGROUND Phrenic nerve stimulation is a therapeutic option for patients with central hypoventilation syndrome due to brain stem and high cervical spinal cord dysfunction. METHODS A 28-year-old woman with high cervical spinal cord injury at the level of C2 had chronic central hypoventilation syndrome, requiring long-term use of a home ventilator Preoperative end tidal CO2 and tidal volume during spontaneous breathing indicated hypoventilation syndrome. Bilateral phrenic nerve stimulation for diaphragmatic pacing was performed with spinal cord stimulators used for chronic pain. The end tidal CO2 pressure (ETCO2), tidal volume, and spontaneous breathing time have improved up to 29 months of postoperative follow-up period. CONCLUSIONS Phrenic nerve stimulation for diaphragmatic pacing can reduce all-time requirement of ventilatory support in patients with high cervical spinal cord injury.

UI MeSH Term Description Entries
D007040 Hypoventilation A reduction in the amount of air entering the pulmonary alveoli. Hypoventilations
D010791 Phrenic Nerve The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm. Nerve, Phrenic,Nerves, Phrenic,Phrenic Nerves
D012122 Ventilators, Mechanical Mechanical devices used to produce or assist pulmonary ventilation. Mechanical Ventilator,Mechanical Ventilators,Respirators,Ventilators, Pulmonary,Pulmonary Ventilator,Pulmonary Ventilators,Ventilator, Pulmonary,Ventilators,Respirator,Ventilator,Ventilator, Mechanical
D002574 Cervical Vertebrae The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK. Cervical Spine,Cervical Spines,Spine, Cervical,Vertebrae, Cervical
D003964 Diaphragm The musculofibrous partition that separates the THORACIC CAVITY from the ABDOMINAL CAVITY. Contraction of the diaphragm increases the volume of the thoracic cavity aiding INHALATION. Respiratory Diaphragm,Diaphragm, Respiratory,Diaphragms,Diaphragms, Respiratory,Respiratory Diaphragms
D004599 Electric Stimulation Therapy Application of electric current in treatment without the generation of perceptible heat. It includes electric stimulation of nerves or muscles, passage of current into the body, or use of interrupted current of low intensity to raise the detection threshold of the skin to pain. Electrotherapy,Electrical Stimulation Therapy,Interferential Current Electrotherapy,Therapeutic Electric Stimulation,Therapeutic Electrical Stimulation,Therapy, Electric Stimulation,Electric Stimulation, Therapeutic,Electrical Stimulation, Therapeutic,Electrotherapy, Interferential Current,Stimulation Therapy, Electric,Stimulation Therapy, Electrical,Stimulation, Therapeutic Electric,Stimulation, Therapeutic Electrical,Therapy, Electrical Stimulation
D005260 Female Females
D006699 Home Care Services Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals. Domiciliary Care,Home Health Care,Care Services, Home,Home Care,Services, Home Care,Care, Domiciliary,Care, Home,Home Care Service,Service, Home Care
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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