SCI patients weaned from mechanical ventilators with diaphragm pacing stimulation

Diaphragm pacing stimulation successfully weans spinal cord injured patients from mechanical ventilators and bridges patients to independent respiration, according to data recently published in the Journal of Trauma and Acute Care Surgery.

Researchers examined the records of 29 patients with spinal cord injury at 16 hospitals in the United States where diaphragm pacing (DP) implantation is approved. Elapsed time from injury to surgery was 40 days.

According to the study results, of the patients who diaphragm muscles responded to stimulation, 72% were completely free of ventilator support in an average of 10 days. Two patients had a delayed weaning of 6 months and three patients had partial weans using DP at time during the day. Researchers found 7 patients were found to have non-stimulated diaphragms from nerve damage. However, 36% of the patients had complete recovery of respiration and DP wires were removed.

“This study provides several important observations. Most notably, laparoscopic diaphragm mapping – an electronic reading of the diaphragm nerves – is safe and can be performed in multiple centers with success,” Raymond Onders, MD, of University Hospital Case Medical Center and professor of surgery at Case Western Reserve University School of Medicine, stated. “In addition, early diaphragm mapping can quickly determine if a phrenic nerve injury is complete, allowing for early ventilator planning and prevention of weaning trials if we find the patient will not be able to be weaned from the ventilator. Finally, DP can successfully wean traumatic cervical SCI patients as evidenced by 72% of the implanted patients being completely weaned from ventilators and 36% with complete recovery and DP removal.”

Reference:

Posluszny JA. J Trauma Acute Care Surg. 2014;doi:10.1097/TA.0000000000000112.

Disclosure: Onders is cofounder of Synapse Biomedical Inc, maker of the Diaphragm Pacing System.