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Journal of Korean Neurosurgical Society 1994;23(2): 253-259.
Respiratory Support using by Electrophrenic Diaphragm Pacemaker: Case Report.
Woo Kyung Kim, Uhn Lee, Koang Hum Bak, Cheol Wan Park
Department of Neurosurgery, Chungang Cil Hospital, Incheon, Korea.
ABSTRACT
The electrophrenic diaphragm pacemaker was implanted bilaterally in a patient with apnea due to high cervical fracture and dislocation. Initially, the phrenic nerves were stimulated during 3-minute period hourly, the PaO2, PaCO2, tidal volume, minutes volume being measured at the beginning and end of each period. Pacing was then gradually increased. The patient's respiration was controlled by the electrophrenic diaphragm pacemaker for up to 30 minutes without mechanical ventilatory support. It is possible that respiratory paralysis associated with quadriplegia has become partially or totally independent of conventional respirator treatment which limits the patient to hospital care. Since completely safe and reliable apnea alarm systems are lacking, quadriplegic patient still requires continuos supervision. However the patient will be able to leave the hospital and perform a more active life, and the care has become easier and less expensive. Further improvement of the technique and equipment may add to the beneficial effects of electrophrenic diaphragm pacemaker.
Key Words: Diaphragm pacemaker; Apnea; Phrenic nerve
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