Diaphragm Pacing for Respiratory Insufficiency
Abstract
Diaphragm pacing (DP) by electrical stimulation of the phrenic nerve offers important advantages to a highly select group of patients with respiratory paralysis. The patient wears an external radiofrequency (RF) transmitter over an implanted receiver, and a stimulating current is induced without the need for any transcutaneous wires. We review the conditions and requirements of patients who may benefit most from DP. We outline the preoperative evaluation and procedures for surgical implantation. We discuss the risk of diaphragmatic fatigue posed by initiation of DP and the use of gradual conditioning to limit this problem. Other problems encountered by patients in the course of DP can be minimized by well-instructed home caregivers and by systematic medical follow-up. Although a few patients derive considerable benefit from DP, many patients with respiratory paralysis are better treated by less invasive means such as nasal bilevel positive airway pressure or intermittent positive pressure ventilation, which we also review.
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FES has clinical applications for phrenic nerve pacing for ventilatory assistance.
“for phrenic nerve pacing for ventilatory assistance”
From A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems (2005) · cites this paper as Chervin and Guilleminault, 1997
In functional electrical stimulation systems for phrenic nerve and pain control, cuff electrodes have replaced button-type epineurial electrodes to reduce the risk of traumatic nerve injury.
“Interestingly, in FES systems for phrenic nerve and for pain control, the cuff electrodes used in the past have been substituted for button-type epineurial electrodes to reduce the risk for traumatic injury to the nerve (Chervin and Guilleminault, 1997; Stanton-Hicks and Salamon, 1997) .”
From A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems (2005) · cites this paper as Chervin and Guilleminault, 1997
Cited by
Sorted by citations
Navarro, X., Krueger, T. B., Lago, N., Micera, S., Stieglitz, T., & Dario, P. (2005) · Journal of the Peripheral Nervous System · doi:10.1111/j.1085-9489.2005.10303.x · Cited by 845 · see citing works
Chapter 2 Bidirectional Interfaces with the Peripheral Nervous System
Micera, S., & Navarro, X. (2009) · International Review of Neurobiology · doi:10.1016/s0074-7742(09)86002-9 · Cited by 69 · see citing works
Romero, E., Denef, J. F., Delbeke, J., Robert, A., & Veraart, C. (2001) · Medical & Biological Engineering & Computing · doi:10.1007/bf02345271 · Cited by 49 · see citing works
- Authors
- Chervin, R. D., & Guilleminault, C.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Chervin, Ronald D.
- Venue
- Journal of Clinical Neurophysiology
- Published
- 1997-09
- Volume
- 14
- Issue
- 5
- Pages
- 369-377
- ISSN
- 0736-0258 (ISSN-L)
- OpenAlex
- W2094899358
- Cited by
- 56
- References
- 0
- Citations by year
- 2022: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2015: 3 · 2012: 2
- FWCI
- 0.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Neurophysiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- diaphragm pacing, phrenic nerve stimulation, respiratory paralysis, respiratory failure, radiofrequency stimulation, diaphragm fatigue, preoperative assessment, implant surgery, bilevel positive airway pressure, intermittent positive pressure ventilation
- MeSH terms
- Contraindications, Diaphragm, Electric Stimulation Therapy, Humans, Phrenic Nerve, Positive-Pressure Respiration, Respiratory Paralysis, Treatment Outcome, Patient Selection, Muscle Fatigue, Prostheses and Implants
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