Marcapasos diafragmático como alternativa a la ventilación mecánica en el paciente con lesión medular cervical

Romero-Ganuza, F.J.; Gambarrutta-Malfatti, C.; Lastra-Buigues, E. Diez de la; Marín-Ruiz, M.Á.; Merlo-González, V.E.; Pantoja, Alberto; García-Moreno, F.J.; Mazaira-Álvarez, J.

doi:10.1016/j.medin.2010.10.003

Cited by 9 publications

(3 citation statements)

References 30 publications

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“…Hirschfeld et al [66], when comparing it to conventional ventilation, found a lower cost due to fewer episodes of infection. Romero-Ganuza et al [67] observed greater survival with a better quality of life due to improved sociability, convenience, and mobility.…”

Section: Weaning: When and Howmentioning

confidence: 99%

Respiratory Management in the Patient with Spinal Cord Injury

Galeiras

Sedes

Fariña

et al. 2013

BioMed Research International

122

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Spinal cord injuries (SCIs) often lead to impairment of the respiratory system and, consequently, restrictive respiratory changes. Paresis or paralysis of the respiratory muscles can lead to respiratory insufficiency, which is dependent on the level and completeness of the injury. Respiratory complications include hypoventilation, a reduction in surfactant production, mucus plugging, atelectasis, and pneumonia. Vital capacity (VC) is an indicator of overall pulmonary function; patients with severely impaired VC may require assisted ventilation. It is best to proceed with intubation under controlled circumstances rather than waiting until the condition becomes an emergency. Mechanical ventilation can adversely affect the structure and function of the diaphragm. Early tracheostomy following short orotracheal intubation is probably beneficial in selected patients. Weaning should start as soon as possible, and the best modality is progressive ventilator-free breathing (PVFB). Appropriate candidates can sometimes be freed from mechanical ventilation by electrical stimulation. Respiratory muscle training regimens may improve patients' inspiratory function following a SCI.

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Section: Weaning: When and Howmentioning

confidence: 99%

Respiratory Management in the Patient with Spinal Cord Injury

Galeiras

Sedes

Fariña

et al. 2013

BioMed Research International

122

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“…The common complications of phrenic pacing include re-operation due to damage of implanted components [ 78 ], although these are decreasing due to improvements in device components; receiver pocket infection; axonal damage of the phrenic nerve has been reported in one patient after 13 years of pacing. Phrenic pacing in patients with spinal injuries leads to improvements in quality of life [ 79 - 81 ]. Compared to mechanical ventilation, phrenic nerve stimulation leads to significant reduction in respiratory tract infections [ 80 ].…”

Section: Introductionmentioning

confidence: 99%

Proceedings of the fourth international conference on central hypoventilation

Trang¹,

Brunet²,

Rohrer³

et al. 2014

Orphanet J Rare Dis

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Central hypoventilation syndromes (CHS) are rare diseases of central autonomic respiratory control associated with autonomous nervous dysfunction. Severe central hypoventilation is the hallmark and the most life-threatening feature. CHS is a group of not-fully defined disorders. Congenital CHS (CCHS) (ORPHA661) is clinically and genetically well-characterized, with the disease-causing gene identified in 2003. CCHS presents at birth in most cases, and associated with Hirschsprung’s disease (ORPHA99803) and neural crest tumours in 20% and 5% of cases, respectively. The incidence of CCHS is estimated to be 1 of 200,000 live births in France, yet remains unknown for the rest of the world. In contrast, late-onset CHS includes a group of not yet fully delineated diseases. Overlap with CCHS is likely, as a subset of patients harbours PHOX2B mutations. Another subset of patients present with associated hypothalamic dysfunction. The number of these patients is unknown (less than 60 cases reported worldwide). Treatment of CHS is palliative using advanced techniques of ventilation support during lifetime. Research is ongoing to better understand physiopathological mechanisms and identify potential treatment pathways.The Fourth International Conference on Central Hypoventilation was organised in Warsaw, Poland, April 13–15, 2012, under the patronage of the European Agency for Health and Consumers and Public Health European Agency of European Community. The conference provided a state-of-the-art update of knowledge on all the genetic, molecular, cellular, and clinical aspects of these rare diseases.

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“…Clínicamente cuando son a nivel cervical, pueden fácilmente ocasionar la muerte del paciente por falla respiratoria. Del mismo modo, a este nivel pueden cursar con una tetraplejia o una tetraparesia incompleta, con un síndrome de Brown-Séquard según el trayecto de la lesión, con un Claude Bernard Horner por compromiso de la vía simpática, con incidencia clara de requerir ventilación mecánica cuando la lesión cervical es alta (sobre C4) por compromiso diafragmático 6 . Las lesiones a nivel dorsal pueden cursar con una paraplejia o paraparesia incompleta, con un síndrome de hemisección medular y con distintos niveles de compromiso sensitivo tanto superficial como profundo, también relacionados con el trayecto de la lesión.…”

Section: Discussionunclassified

Herida penetrante raquimedular por arma blanca: a propósito de dos casos

et al. 2021

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Se describen dos casos operados por el autor: El 1° un paciente de 30 años que sufrió una agresión por terceros con arma blanca con penetración de columna y médula cervical a nivel de C2-C3, el cual ingresó consciente, tetrapléjico, con un Síndrome de Claude Bernard Horner izquierdo y con compromiso respiratorio leve. El 2° un paciente de 20 años que también sufrió agresión por terceros con arma blanca con penetración de columna y médula a nivel dorsal, el cual ingresó con compromiso motor distal en L5-S1 izquierda e hipoestesia distal bilateral. En ambos casos se procedió a operar de urgencia para la extracción del elemento extraño, comprobándose que éste transfixiaba la médula en los niveles descritos. En el postoperatorio los pacientes evolucionaron con recuperación parcial de su compromiso neurológico, siendo dados de alta el primero con una hemiplejia izquierda y el segundo solo con un área de hipoestesia distal en la pierna izquierda.

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Marcapasos diafragmático como alternativa a la ventilación mecánica en el paciente con lesión medular cervical

Cited by 9 publications

References 30 publications

Respiratory Management in the Patient with Spinal Cord Injury

Respiratory Management in the Patient with Spinal Cord Injury

Proceedings of the fourth international conference on central hypoventilation

Herida penetrante raquimedular por arma blanca: a propósito de dos casos

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