Document Detail

Transdiaphragmatic pressure in quadriplegic individuals ventilated by diaphragmatic pacemaker.
MedLine Citation:
PMID:  8733497     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Electrophrenic pacing can be used in the management of ventilatory failure in quadriplegic patients. A study was undertaken to determine the pattern of transdiaphragmatic pressure (PDI) during the conditioning phase of electrophrenic pacing to see if it had a possible role in optimising the process of conditioning. METHODS: The tidal volume (TV) and PDI were measured in a group of six quadriplegic patients commencing ventilation by low frequency pulse stimulation (7-10 Hz) and low respiratory rate stimulation (< 10 breaths/min). RESULTS: Tidal volume increased between baseline and month 1 (4.33 ml/kg, p < 0.001) and between months 1 and 2 (3.00 ml/kg, p < 0.05) and then stabilised. PDI was higher during bilateral diaphragmatic pacing (mean (SD) 1.73 (0.30) kPa) than with either left (1.15 (0.34) kPa) or right (0.86 (0.37) kPa) unilateral pacing. PDI varied throughout the observation period, probably by interaction between recovery of the diaphragmatic fibres and the pacing regimen. CONCLUSIONS: Patients with quadriplegia due to high spinal injury can be maintained with ventilation by continuous electrophrenic pacing. The control criteria used in this study for pacing were tidal volume and the patient's tolerance, and the PDI measurement did not contribute any additional information to help with managing the conditioning process.
H Garrido-García; P Martín-Escribano; J Palomera-Frade; O Arroyo; J L Alonso-Calderón; J Mazaira-Alvarez
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Thorax     Volume:  51     ISSN:  0040-6376     ISO Abbreviation:  Thorax     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-10-09     Completed Date:  1996-10-09     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  420-3     Citation Subset:  IM    
Medical School, Universidad Autónoma de Madrid, Spain.
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MeSH Terms
Child, Preschool
Electric Stimulation*
Phrenic Nerve*
Quadriplegia / complications*
Respiratory Paralysis / etiology,  therapy*
Tidal Volume

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