Extubation failure due to phrenic nerve injury.
A 26 week gestation infant had an increasingly elevated right hemidiaphragm following drainage of bilateral pleural effusions and failed extubation on numerous occasions. Electric stimulation of the phrenic nerves revealed absent activity on the right, indicating phrenic nerve injury from chest tube drain insertion. Diaphragmatic plication was performed and the infant successfully extubated four days later.
Williams
O
O
Children Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London SE5 9RS, UK.
Greenough
A
A
Mustfa
N
N
Haugen
S
S
Rafferty
G R
GR
D015505:Chest Tubes / Q000009:adverse effects*; D004558:Electric Stimulation; D004576:Electromyography; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010791:Phrenic Nerve / Q000293:injuries*; D011859:Radiography; D012121:Respiration, Artificial / Q000379:methods; D012127:Respiratory Distress Syndrome, Newborn / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D017211:Treatment Failure; D015300:Ventilator Weaning