Diaphragm pacing.

Diaphragm pacing is an established mode of ventilation for patients with upper motor neuron injury and preserved phrenic nerve function. Careful patient evaluation with regard to phrenic nerve function, motivation, and adequate psychosocial support is paramount for successful pacing. In properly selected individuals, full-time continuous bilateral pacing for several years has been demonstrated with advantages of increased independence and productivity, fewer tracheal tube complications, and improved phonation. Ongoing research in the field of diaphragm pacing includes refinements in electrode placement and continued testing of totally implantable devices.