Phrenic nerve stimulation: the Australian experience

J Clin Neurosci. 2010 Feb;17(2):205-8. doi: 10.1016/j.jocn.2009.06.012. Epub 2010 Jan 6.

Abstract

Phrenic nerve stimulation is a technique whereby a nerve stimulator provides electrical stimulation of the phrenic nerve to cause diaphragmatic contraction. The most common indications for this procedure are central alveolar hypoventilation and high quadriplegia. This paper reviews the available data on the 19 patients treated with phrenic nerve stimulation in Australia to date. Of the 19 patients, 14 required pacing due to quadriplegia, one had congenital central hypoventilation syndrome and one had brainstem encephalitis. Information was unavailable for the remaining three patients. Currently, 11 of the pacers are known to be actively implanted, with the total pacing duration ranging from 1 to 21 years (mean 13 years). Eight of the 19 patients had revision surgeries. Four of these were to replace the original I-107 system (which had a 3-5-year life expectancy) with the current I-110 system, which is expected to perform electrically for the patient's lifetime. Three patients had revisions due to mechanical failure. The remaining patients' notes were incomplete. These data suggest that phrenic nerve stimulation can be used instead of mechanical ventilators for long-term ongoing respiratory support.

Publication types

  • Case Reports

MeSH terms

  • Australia
  • Brain Stem Infarctions / complications
  • Brain Stem Infarctions / pathology
  • Diaphragm / innervation*
  • Diaphragm / physiopathology
  • Efferent Pathways / injuries
  • Efferent Pathways / pathology
  • Efferent Pathways / physiopathology
  • Electric Stimulation Therapy / methods*
  • Encephalitis / complications
  • Encephalitis / pathology
  • Equipment Failure
  • Fatal Outcome
  • Humans
  • Neck / anatomy & histology
  • Neck / surgery
  • Neurosurgical Procedures / instrumentation
  • Neurosurgical Procedures / methods*
  • Pacemaker, Artificial / trends*
  • Phrenic Nerve / anatomy & histology
  • Phrenic Nerve / physiology
  • Phrenic Nerve / surgery*
  • Quadriplegia / complications
  • Quadriplegia / etiology
  • Quadriplegia / physiopathology
  • Respiration, Artificial / instrumentation
  • Respiration, Artificial / methods
  • Respiratory Center / pathology
  • Respiratory Center / physiopathology
  • Respiratory Paralysis / etiology
  • Respiratory Paralysis / physiopathology
  • Respiratory Paralysis / therapy*
  • Retrospective Studies
  • Sleep Apnea, Central / complications
  • Sleep Apnea, Central / physiopathology
  • Sleep Apnea, Central / therapy
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / pathology
  • Spinal Cord Injuries / physiopathology
  • Thoracic Cavity / anatomy & histology
  • Thoracic Cavity / surgery
  • Thoracotomy
  • Treatment Outcome