Brule J F, Leriche B, Normand J, Morel P
Service de réanimation, Etablissements Hélio marins, Berck sur Mer.
Agressologie. 1993;34 Spec No 2:90-2.
Electrophrenic Respiration (REP) is a technic specially reserved to the patients with a first motoneuron disease but having moreover normal phrenic nerve, diaphragm and lungs. Electrical pulse trains are applied to the phrenic nerve by a surgically implanted electrode. They produce rhythmic inspiratory diaphragm contractions; expiratory time is passive. The energy is delivered by a transcutaneous radiofrequency external pacer. Before to decide to implant a REP device, it should be wait for a sufficient time to avoid either a possible return to a spontaneous breathing or, on the contrary, a peripheral nerve disease initially unrecognized. After regularly repeated external detection exams, surgery must be done gently on a stabilised patient, out of infection and, if possible, without intellectual trouble. The training needs a long time (many months) since to become fatigue-resistant a paced muscle must be trained progressively and durably. In that way the results are generally good, as the 13 patients we have implanted may give an evidence.
膈神经电刺激呼吸（REP）是一种专门用于患有原发性运动神经元疾病但膈神经、膈肌和肺部功能正常的患者的技术。通过手术植入的电极将电脉冲序列施加到膈神经上。它们会引起膈肌有节奏的吸气收缩；呼气时间是被动的。能量由经皮射频外部起搏器提供。在决定植入REP设备之前，应该等待足够的时间，以避免可能恢复自主呼吸，或者相反，避免最初未被识别的周围神经疾病。在定期重复进行外部检测检查之后，必须在病情稳定、无感染且尽可能无智力障碍的患者身上轻柔地进行手术。训练需要很长时间（数月），因为要使起搏的肌肉具有抗疲劳能力，必须进行渐进且持久的训练。这样一来，结果通常是良好的，正如我们植入的13名患者所证明的那样。
