Continuous bilateral electrophrenic pacing in an infant with total diaphragmatic paralysis

Threshold Currents of Platinum Electrodes used for Functional Electrical Stimulation of the Phrenic Nerves for Treatment of Central Apnea

“…Continuous electrical stimulation of a muscle at its fusion frequency causes electrically induced muscle fatigue and, when carried on over a longer period of time, may cause complete muscle destruction . This is no problem when functional electrical stimulation is used for short actions, like standing up or hand grip; however, contraction of the human diaphragm is necessary 8–20 times a minute, around the clock and life‐long.…”

“…Continuous electrical stimulation of a muscle at its fusion frequency causes electrically induced muscle fatigue 1 and, when carried on over a longer period of time, may cause complete muscle destruction. 2 This is no problem when functional electrical stimulation is used for short actions, like standing up or hand grip; however, contraction of the human diaphragm is necessary 8-20 times a minute, around the clock and lifelong. The electrically induced fatigue is absent at frequencies below 8 Hz, 3 but a switch to 8 Hz from the fusion frequency of the human diaphragm, being around 40 Hz, would cause intolerable trembling of the diaphragm.…”

Permanent artificial respiration by diaphragm pacemaker in tetraplegic children

“…Although in the literature there are reports of continuous bilateral pacing of the diaphragm in infants (Radecki, Tomatis, 1976), with apparent success, we are not at all convinced by them, because of limited details of criteria and of documentation dealing with the death of children in the short term.…”

Restoration of Function in the Paralyzed Rabbit Orbicularis Oculi Muscle by Direct Functional Electrical Stimulation

“…In 1960, Liberson, et al 18 introduced the concept of functional electrical stimulation (FES) to restore foot dorsiflexor activity in hemiplegic patients. Subsequently, FES has been applied to other areas of paralysis, including diaphragmatic pacing, bladder pacing, and control of paralyzed limbs 19‐21 . In these applications, however, the paralysis was the result of a central or upper motoneuron lesion.…”

“…Subsequently, FES has been applied to other areas of paralysis, including diaphragmatic pacing, bladder pacing, and control of paralyzed limbs. [19][20][21] In these applications, however, the paralysis was the result of a central or upper motoneuron lesion. Thus, the paralyzed muscle continued to have intact lower motoneurons and motor end plates.…”