Comparative study of electrophrenic nerve stimulation and mechanical ventilatory support in traumatic spinal cord injury

Carter, R E; Donovan, William H.; Halstead, Lauro S.; Wilkerson, Mark

doi:10.1038/sc.1987.16

Cited by 48 publications

(45 citation statements)

References 2 publications

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“…The mean age of the patients studied was significantly lower for the DP group, a fact that has also been reported in the compara tive study by Carter et al 13 In our series, both groups were homogeneous with respect to lesion level, aetiology and admission delay. Nevertheless, it should be noted that three patients with a C3 level and phrenic nerve damage had to be excluded for DP.…”

Section: Discussionsupporting

confidence: 73%

Tracheostomy ventilation versus diaphragmatic pacemaker ventilation in high spinal cord injury

et al. 1994

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We have made a retrospective comparative study of patients with spinal cord injury, nine with a diaphragmatic pacemaker and 13 with mechanical ventilation. Clinical outcome, cost and subjective satisfaction with both modalities have been evaluated. The functional status was the same with both types of treatment. Proper management of an electric wheelchair and optimal phonation were attained, respectively, in 100% and 89% of pacers and in 77% and 77% of mechanically ventilated. The rate of hospital discharge and satisfaction with the treatment were significantly better for pacers. The time devoted to ventilatory assistance and cost were also more favourable in this group.

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Section: Discussionsupporting

confidence: 73%

Tracheostomy ventilation versus diaphragmatic pacemaker ventilation in high spinal cord injury

et al. 1994

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“…With PNS, additional reasons for part-time use are an intermittently working respiratory centre, one-side implantation or being younger than 10 years of age; for the latter, 12 h per day is recommended maximum stimulation time. The relation of full-time to part-time use of PNS/DP is also about the same in the patient populations of Carter et al, 9 Wolf et al, 11 Soni 13 and of Similowski and Derenne 12 ; the latter stressed the fact that irrational beliefs frequently prevent the patients from using PNS full-time. 12 Full-time use of DP for all patients is reported only by Esclarin et al…”

Section: Part-time Usementioning

confidence: 50%

“…We think the striking difference in RI between patients on PNS and MV ( found RIs in eight patients on CS and in six patients on MV, whereas Carter et al 9 did not report on this detail.…”

Section: Respiratory Tract Infectionmentioning

confidence: 67%

“…Carter et al 9 found longer survival on MV, but estimate that 'the longevity in this group (MV) may be artificially inflated' due to the long study period that includes different ways of patient selection and different versions of devices. Esclarin et al 10 report on longer life with DP than with MV, but without significant difference.…”

Section: Survivalmentioning

confidence: 99%

“…1 Previous publications comparing MV and electroventilation for SCI patients did not present evidence in favour of one or the other solution, but reported the opinions of authors and patients. [9][10][11][12][13] We, therefore, when starting to use PNS in Hamburg, decided to collect prospectively clinically meaningful data. Our main outcomes were survival, frequency of respiratory tract infection (RI) and resocialization, that is living at home, learning or earning one's livelihood.…”

Section: Introductionmentioning

confidence: 99%

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Mechanical ventilation or phrenic nerve stimulation for treatment of spinal cord injury-induced respiratory insufficiency

et al. 2008

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Study design: Prospective clinical study of two treatments. Objective: To compare mechanical ventilation (MV) with phrenic nerve stimulation (PNS) for treatment of respiratory device-dependent (RDD) spinal cord-injured (SCI) patients. Setting: Department for spinal cord-injured patients of an insurance-company-run trauma hospital in Hamburg, Germany. Methods: Prospective data collection of treatment-related data over 20 years. Results: In total, 64 SCI-RDD patients were treated during the study period. Of these, 32 of the patients with functioning phrenic nerves and diaphragm muscles were treated with PNS and 32 patients with destroyed phrenic nerves were mechanically ventilated. Incidence of respiratory infections (RIs per 100 days) prior to use of final respiratory device was equal in both groups, that is (median (interquartile range)) 1.43 (0.05-3.92) with PNS and 1.33 (0.89-2.21) with MV (P ¼ 0.888); with final device in our institution it was 0 (0-0.92) with PNS and 2.07 (1.49-4.19) with MV (Po0.001); at final location it was 0 (0-0.02) with PNS and 0.14 (0-0.31) with MV (Po0.001). Thus, compared to MV, respiratory treatment with PNS significantly reduces frequency of RI. Quality of speech is significantly better with PNS. Nine patients with PNS, but only two with MV, were employed or learned after rehabilitation (P ¼ 0.093). The primary investment in the respiratory device is higher with PNS, but it can be paid off in our setting within 1 year because of the reduced amount of single use equipment, easier nursing and fewer RIs compared to MV. Conclusions: PNS instead of MV for treatment of SCI-RDD reduces RIs, running costs of respiratory treatment and obviously improves patients' quality of life.

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Neuromuscular electrical stimulation in neurorehabilitation

2007

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This review provides a comprehensive overview of the clinical uses of neuromuscular electrical stimulation (NMES) for functional and therapeutic applications in subjects with spinal cord injury or stroke. Functional applications refer to the use of NMES to activate paralyzed muscles in precise sequence and magnitude to directly accomplish functional tasks. In therapeutic applications, NMES may lead to a specific effect that enhances function, but does not directly provide function. The specific neuroprosthetic or "functional" applications reviewed in this article include upper- and lower-limb motor movement for self-care tasks and mobility, respectively, bladder function, and respiratory control. Specific therapeutic applications include motor relearning, reduction of hemiplegic shoulder pain, muscle strengthening, prevention of muscle atrophy, prophylaxis of deep venous thrombosis, improvement of tissue oxygenation and peripheral hemodynamic functioning, and cardiopulmonary conditioning. Perspectives on future developments and clinical applications of NMES are presented.

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Comparative study of electrophrenic nerve stimulation and mechanical ventilatory support in traumatic spinal cord injury

Cited by 48 publications

References 2 publications

Tracheostomy ventilation versus diaphragmatic pacemaker ventilation in high spinal cord injury

Tracheostomy ventilation versus diaphragmatic pacemaker ventilation in high spinal cord injury

Mechanical ventilation or phrenic nerve stimulation for treatment of spinal cord injury-induced respiratory insufficiency

Neuromuscular electrical stimulation in neurorehabilitation

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