Patients with high spinal cord injuries: evaluation of diaphragmatic function, indication of electrophrenic ventilation
Brule, J.F.; Leriche, B.; Normand, J.; Morel, P.
Agressologie Revue Internationale de Physio-Biologie et de Pharmacologie Appliquees Aux Effets de l'Agression 34(Special Issue 2): 90-92
1993
ISSN/ISBN: 0002-1148 PMID: 7802153 Document Number: 419341
Electrophrenic Respiration (REP) is a technic specially reserved to the patients with a first motoneuron disease but having moreover normal phrenic nerve, diaphragm and lungs. Electrical pulse trains are applied to the phrenic nerve by a surgically implanted electrode. They produce rhythmic inspiratory diaphragm contractions; expiratory time is passive. The energy is delivered by a transcutaneous radiofrequency external pacer. Before to decide to implant a REP device, it should be wait for a sufficient time to avoid either a possible return to a spontaneous breathing or, on the contrary, a peripheral nerve disease initially unrecognized. After regularly repeated external detection exams, surgery must be done gently on a stabilised patient, out of infection and, if possible, without intellectual trouble. The training needs a long time (many months) since to become fatigue-resistant a paced muscle must be trained progressively and durably. In that way the results are generally good, as the 13 patients we have implanted may give an evidence.