[Patients with high spinal cord injuries: evaluation of diaphragmatic function, indication of electrophrenic ventilation].
Electrophrenic Respiration (REP) is a technic specially reserved to the patients with a first motoneuron disease but having moreover normal phrenic nerve, diaphragm and lungs. Electrical pulse trains are applied to the phrenic nerve by a surgically implanted electrode. They produce rhythmic inspiratory diaphragm contractions; expiratory time is passive. The energy is delivered by a transcutaneous radiofrequency external pacer. Before to decide to implant a REP device, it should be wait for a sufficient time to avoid either a possible return to a spontaneous breathing or, on the contrary, a peripheral nerve disease initially unrecognized. After regularly repeated external detection exams, surgery must be done gently on a stabilised patient, out of infection and, if possible, without intellectual trouble. The training needs a long time (many months) since to become fatigue-resistant a paced muscle must be trained progressively and durably. In that way the results are generally good, as the 13 patients we have implanted may give an evidence.
Brule
J F
JF
Service de réanimation, Etablissements Hélio marins, Berck sur Mer.
Leriche
B
B
Normand
J
J
Morel
P
P
D003964:Diaphragm / Q000503:physiopathology; D004599:Electric Stimulation Therapy; D006801:Humans; D011782:Quadriplegia / Q000209:etiology / Q000628:therapy; D012133:Respiratory Paralysis / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*
Traumatisé médullaire haut: évaluation de la fonction diaphragmatique, indication de la ventilation électrophrénique.