title: Diaphragmatic pacing in spinal cord injury.
abstract: After cervical spinal cord injuries, many patients are unable to sustain independent ventilation because of a disruption of diaphragm innervation and respiratory functioning. If phrenic nerve function is preserved, the patient may be able to tolerate exogenous pacing of the diaphragm via electrical stimulation. Previously this was accomplished by stimulation directly to the phrenic nerves, but may be accomplished less invasively by percutaneously stimulating the diaphragm itself. The benefits, when compared with mechanical ventilation, include a lower rate of pulmonary complications, improved venous return, more normal breathing and speech, facilitation of eating, cost-effectiveness, and increased patient mobility.
authors: Department of Physical Medicine and Rehabilitation, University of Miami-Miller School of Medicine, 1120 North West 14th Street, Suite 936, Miami, FL 33136, USA. Electronic address: kdalal@med.miami.edu.
authors: Kevin
authors: K
authors: Dalal
authors: Rammelkamp Research Center, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
authors: Anthony F
authors: AF
authors: DiMarco
mesh_terms: D003964:Diaphragm / Q000294:innervation / Q000503:physiopathology; D004599:Electric Stimulation Therapy / Q000295:instrumentation; D004567:Electrodes, Implanted; D006801:Humans; D018579:Patient Selection; D010791:Phrenic Nerve / Q000503:physiopathology; D012119:Respiration; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D015300:Ventilator Weaning
keywords: Diaphragm; Phrenic nerve; Tetraplegia