Mayr W, Bijak M, Girsch W, Holle J, Lanmüller H, Thoma H, Zrunek M
Department of Biomedical Engineering and Physics, Wilhelminenspital, Vienna, Austria.
ASAIO J. 1993 Jul-Sep;39(3):M729-35.
Between 1983 and 1992, 23 patients with complete ventilatory insufficiency of differing etiologies were treated with an eight channel implant (Medimplant Inc., Vienna) for fatigue free stimulation of both phrenic nerves. Data for 15 patients with high spinal cord lesions (ages: 9-51 years) are summarized: 1) level of lesion: C0, 3 patients; C1/C2, 4; C2/C3, 8; 2) time between incident and implantation: 3-14 months; 3) diaphragm training: 1-22 months; 4) chronic pacing: 5-83 months; 5) tracheostomy closed: 7 patients; 6) living permanently at home: 13 patients; 7) respiratory rate per minute: 12-17; 8) duration of inspiration: 1.0-1.3 sec; 9) tidal volume: 7-20 ml/kg body weight; 10) volume per minute: 121-198 ml/kg body weight; 11) pH: 7.39-7.42; 12) pCO2: 22.9-38.6 mmHg; 13) pO2: 81.2-104.5 mmHg; and 14) died by December 1992, 4 patients. All currently available implants for phrenic pacing need an external power supply and radio control. The authors have developed and tested the first fully implantable device. Features of this implant include an electronic circuit based on the microcontroller MC68HC705C8; surface mounted technology (SMD); eight channels; constant current source adjustable to 5 mA in 256 steps, impulse duration: 100-1000 musec, stimulation frequency: 1-33 Hz; and minimum lifetime: 3 years. The implant is programmed via bidirectional radio transmission using an IBM compatible computer. The dimensions, including battery, eight electrode connectors, and antenna, are 67 x 48 x 13 mm. The implant weights 58 g. This new device may improve patients' safety and quality of life in the near future.
1983年至1992年间，23例病因各异的完全通气功能不全患者接受了八通道植入装置（维也纳Medimplant公司）治疗，以实现对双侧膈神经的无疲劳刺激。总结了15例高位脊髓损伤患者（年龄9至51岁）的数据：1）损伤平面：C0，3例；C1/C2，4例；C2/C3，8例；2）事故与植入之间的时间：3至14个月；3）膈肌训练：1至22个月；4）长期起搏：5至83个月；5）气管造口关闭：7例；6）永久居家生活：13例；7）每分钟呼吸频率：12至17次；8）吸气持续时间：1.0至1.3秒；9）潮气量：7至20毫升/千克体重；10）每分钟通气量：121至198毫升/千克体重；11）pH值：7.39至7.42；12）二氧化碳分压：22.9至38.6毫米汞柱；13）氧分压：81.2至104.5毫米汞柱；14）截至1992年12月死亡4例。目前所有用于膈神经起搏的植入装置都需要外部电源和无线电控制。作者研发并测试了首个完全可植入装置。该植入装置的特点包括基于微控制器MC68HC705C8的电子电路；表面贴装技术（SMD）；八通道；恒流源，可在256步内调节至5毫安，脉冲持续时间：100至1000微秒，刺激频率：1至33赫兹；最短使用寿命：3年。该植入装置通过使用IBM兼容计算机的双向无线电传输进行编程。其尺寸（包括电池、八个电极连接器和天线）为67×48×13毫米。植入装置重58克。这种新装置可能在不久的将来提高患者的安全性和生活质量。
