title: Evaluation of phrenic nerve and diaphragm function with peripheral nerve stimulation and M-mode ultrasonography in potential pediatric phrenic nerve or diaphragm pacing candidates.
abstract: Assessing phrenic nerve function in the setting of diaphragmatic paralysis in diaphragm pacing candidates can be challenging. Traditional imaging modalities and electrodiagnostic evaluations are technically difficult. Either modality alone is not a direct measure of the function of the phrenic nerve and diaphragm unit. In this article, the authors present their method for evaluating phrenic nerve function and the resulting diaphragm function. Stimulating the phrenic nerve with transcutaneous stimulation and directly observing the resulting movement of the hemidiaphragm with M-mode ultrasonography provides quantitative data for predicting the success of advancing technologies such as phrenic nerve pacing and diaphragm pacing.
authors.affiliation: Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Rady Children's Hospital San Diego, University of California San Diego, 3020 Children's Way, MC 5096, San Diego, CA 92123, USA. Electronic address: askalsky@rchsd.org.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Skalsky
authors.affiliation: Division of Pediatric Respiratory Medicine, Department of Pediatrics, Rady Children's Hospital San Diego, University of California San Diego, 3020 Children's Way, San Diego, CA, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lesser
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of California Davis School of Medicine, 4860 Y Street, Sacramento, CA 95817, USA.
authors.forename: Craig M
authors.initials: CM
authors.lastname: McDonald
mesh_terms: D000293:Adolescent; D002648:Child; D003964:Diaphragm / Q000000981:diagnostic imaging* / Q000294:innervation / Q000503:physiopathology*; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D004576:Electromyography; D006801:Humans; D008297:Male; D009431:Neural Conduction; D018579:Patient Selection; D010791:Phrenic Nerve / Q000503:physiopathology*; D011846:Radio Waves; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D014463:Ultrasonography / Q000379:methods
keywords: Diaphragm pacing; Pediatric; Phrenic nerve pacing; Spinal cord injury; Ultrasonography