Department of Neurosurgery, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia.
J Clin Neurosci. 2010 Feb;17(2):205-8. doi: 10.1016/j.jocn.2009.06.012. Epub 2010 Jan 6.
Phrenic nerve stimulation is a technique whereby a nerve stimulator provides electrical stimulation of the phrenic nerve to cause diaphragmatic contraction. The most common indications for this procedure are central alveolar hypoventilation and high quadriplegia. This paper reviews the available data on the 19 patients treated with phrenic nerve stimulation in Australia to date. Of the 19 patients, 14 required pacing due to quadriplegia, one had congenital central hypoventilation syndrome and one had brainstem encephalitis. Information was unavailable for the remaining three patients. Currently, 11 of the pacers are known to be actively implanted, with the total pacing duration ranging from 1 to 21 years (mean 13 years). Eight of the 19 patients had revision surgeries. Four of these were to replace the original I-107 system (which had a 3-5-year life expectancy) with the current I-110 system, which is expected to perform electrically for the patient's lifetime. Three patients had revisions due to mechanical failure. The remaining patients' notes were incomplete. These data suggest that phrenic nerve stimulation can be used instead of mechanical ventilators for long-term ongoing respiratory support.
膈神经刺激是一种通过神经刺激器对膈神经进行电刺激以引起膈肌收缩的技术。该程序最常见的适应证是中枢性肺泡通气不足和高位四肢瘫痪。本文回顾了迄今为止在澳大利亚接受膈神经刺激治疗的 19 名患者的可用数据。在这 19 名患者中，14 名因四肢瘫痪需要起搏，1 名患有先天性中枢性通气不足综合征，1 名患有脑干脑炎。其余 3 名患者的信息无法获得。目前，已知有 11 名起搏器正在积极植入，起搏总时间从 1 到 21 年不等（平均 13 年）。19 名患者中有 8 人进行了修订手术。其中 4 人用当前的 I-110 系统替换了原有的 I-107 系统（预计使用寿命为 3-5 年），该系统有望为患者的余生提供电刺激。3 名患者因机械故障进行了修订。其余患者的记录不完整。这些数据表明，膈神经刺激可用于替代机械呼吸机进行长期持续呼吸支持。
