Phrenic Nerve PacingBi0108 - 30 April 03.ppt

Phrenic Nerve PacingBi0108 - 30 April 03 Introduction Injury to the spinal cord or brain stem may damage the nerve cells that stimulate the phrenic nerve, which facilitates contraction of the diaphragm necessary for breathing. Phrenic nerve pacing, which uses and electrode implanted in the chest to stimulate the phrenic nerve, may benefit certain patients who are dependent on a respirator. If your doctor believes that you may be a good candidate for this procedure, he or she may order tests called phrenic nerve EMGs. These tests will usually indicate if phrenic nerve pacing is possible for you. The equipment required for phrenic nerve pacing is much smaller and more portable than a mechanical ventilator. Phrenic nerve pacers improve respiratory physiology because air is drawn into the lungs naturally by diaphragmatic contractions, rather than air forced into the lungs under pressure from a mechanical ventilator. Indications spinal cord injury or disease, including quadriplegia central alveolar hypoventilation decreased day or night ventilatory drive (i.e. sleep apnea, Ondines Curse) brain stem injury or disease damaged phrenic nerve(s) Device The device provides electrical stimulation to the muscle and nerves that run through the diaphragm. When the muscle is stimulated, it contracts, causing a vacuum-like effect in the chest cavity that causes air to enter the lungs. When the contraction eases, the air is expelled passively. This process is repeated 10-14 times per minute. This is essentially the same process as normal breathing. Device (cont.) The pacing system consists of: Four Teflon embedded Electrodes: deliver a pulse directly to the phrenic nerve causing the diaphragm muscle to contract. The quadripolar system sequentially stimulates each of the four electrodes during a given breath, thereby decreasing the number of impulses delivered to a single quadrant of the phrenic nerve by 75% during inspiration. This quadripolar electrode system ai