Injuries to the phrenic nerve resulting in diaphragmatic paralysis with special reference to stretch trauma

Iverson, Leigh I.G.; Mittal, Ajay Kumar; Dugan, David; Samson, Paul C.

doi:10.1016/0002-9610(76)90058-1

Cited by 77 publications

(41 citation statements)

References 6 publications

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“…1,3 Diaphragmatic eventration can also result from excessive chronic stretching of the diaphragm. 4 In our patient, the cardiac irritability (SVT) was the result of his liver being displaced into the right hemithorax and compressing the right side of the heart. This was due to the extensive stretching of the right hemidiaphragm from his large polycystic native liver and its pliability; this allowed the new, relatively small graft to move into the thoracic space, usually with changes in position.…”

Section: Discussionmentioning

confidence: 81%

Right atrial compression due to diaphragmatic eventration after liver transplantation: Successful treatment by diaphragmatic plication

et al. 2014

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Section: Discussionmentioning

confidence: 81%

Right atrial compression due to diaphragmatic eventration after liver transplantation: Successful treatment by diaphragmatic plication

et al. 2014

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“…Incomplete root avulsion could be the causes of both axonal injury and conduction block. In addition, the phrenic nerve palsy by stretch injury was also previously reported (12,13).…”

Section: Discussionmentioning

confidence: 94%

Acute Cervical Motor Radiculopathy Induced by Neck and Limb Immobilization in a Patient with Parkinson Disease

2006

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“…The already mentioned strategies to avoid residual air space such as pneumoperitoneum, pleural tenting, and intraoperative crushing of the phrenic nerve are so far the most frequently used. Iverson et al reported in 1976 of 50% diminished diaphragmatic function, and 20% permanent diaphragmatic paralysis after crushing the phrenic nerve [7]. There is no controlled data available on this subject.…”

Section: Discussionmentioning

confidence: 99%

Reduction of airspace after lung resection through controlled paralysis of the diaphragm☆

Carboni

Vogt

Küster

et al. 2008

European Journal of Cardio-Thoracic Surgery

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Objectives: Residual airspace following thoracic resections is a common clinical problem. Persistent air leak, prolonged drainage time, and reduced hemostasis extend hospital stay and morbidity. We report a trial of pharmacologic-induced diaphragmatic paralysis through continuous paraphrenic injection of lidocaine to reduced residual airspace. The objectives were confirmation of diaphragmatic paralysis and possible procedure related complications. Methods: Six eligible patients undergoing resectional surgery (lobectomy or bilobectomy) were included. Inclusion criteria consisted of: postoperative predicted FEV1 greater than 1300 ml, right-sided resection, absence of parenchymal lung disease, no class III antiarrhythmic therapy, absence of hypersensitivity reactions to lidocaine, no signs of infection, and informed consent. Upon completion of resection an epidural catheter was attached in the periphrenic tissue on the proximal pericardial surface, externalized through a separate parasternal incision, and connected to a perfusing system injecting lidocaine 1% at a rate of 3 ml/h (30 mg/h). Postoperative ICU surveillance for 24 h and daily measurement of vital signs, drainage output, and bedside spirometry were performed. Within 48 h fluoroscopic confirmation of diaphragmatic paralysis was obtained. The catheter removal coincided with the chest tube removal when no procedural related complications occurred. Results: None of the patients reported respiratory impairment. Diaphragmatic paralysis was documented in all patients. Upon removal of catheter or discontinuation of lidocaine prompt return of diaphragmatic motility was noticed. Two patients showed postoperative hemodynamic irrelevant atrial fibrillation. Conclusion: Postoperative paraphrenic catheter administration of lidocaine to ensure reversible diaphragmatic paralysis is safe and reproducible. Further studies have to assess a benefit in terms of reduction in morbidity, drainage time, and hospital stay, and determine the patients who will profit. #

show abstract

Injuries to the phrenic nerve resulting in diaphragmatic paralysis with special reference to stretch trauma

Cited by 77 publications

References 6 publications

Right atrial compression due to diaphragmatic eventration after liver transplantation: Successful treatment by diaphragmatic plication

Right atrial compression due to diaphragmatic eventration after liver transplantation: Successful treatment by diaphragmatic plication

Acute Cervical Motor Radiculopathy Induced by Neck and Limb Immobilization in a Patient with Parkinson Disease

Reduction of airspace after lung resection through controlled paralysis of the diaphragm☆

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