Diaphragmatic Pacing in Spinal Cord Injury

Abstract

Spinal Cord injury is a disabling condition which affects the respiratory system. The most affected neurological level is the cervical spine. Many patients with cervical spinal cord injury are unable to sustain independent ventilation and require mechanical ventilation. Long term use of mechanical ventilation is associated with poor quality of life, increased morbidity, and mortality. In patients with intact phrenic nerve, diaphragmatic pacing can be used to help wean the patients off mechanical ventilation. In this review, we summarize the indications, contraindications, benefits, safety, and effectiveness of diaphragmatic pacing. We also report a brief case of a 62-year-old male with quadriplegia secondary to C2-C3 fracture who was intubated after drowning but was extubated with the help of diaphragmatic pacing.

Keywords

• cervical spinal injury
• diaphragmatic pacing
• mechanical ventilation