Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/160
Title: Diaphragmatic pacing stimulation in spinal cord injury: anesthetic and perioperative management
Authors: TEDDE, Miguel L.VASCONCELOS FILHO, PauloHAJJAR, Ludhmila AbrahaoALMEIDA, Juliano Pinheiro deFLORA, Gustavo FagundesOKUMURA, Erica MieOSAWA, Eduardo A.FUKUSHIMA, Julia TizueTEIXEIRA, Manoel JacobsenGALAS, Filomena Regina Barbosa GomesJATENE, Fabio BiscegliAULER JR., Jose Otavio Costa
Citation: CLINICS, v.67, n.11, p.1265-1269, 2012
Abstract: OBJECTIVE: The standard therapy for patients with high-level spinal cord injury is long-term mechanical ventilation through a tracheostomy. However, in some cases, this approach results in death or disability. The aim of this study is to highlight the anesthetics and perioperative aspects of patients undergoing insertion of a diaphragmatic pacemaker. METHODS: Five patients with quadriplegia following high cervical traumatic spinal cord injury and ventilator-dependent chronic respiratory failure were implanted with a laparoscopic diaphragmatic pacemaker after preoperative assessments of their phrenic nerve function and diaphragm contractility through transcutaneous nerve stimulation. ClinicalTrials.gov:NCT01385384. RESULTS: The diaphragmatic pacemaker placement was successful in all of the patients. Two patients presented with capnothorax during the perioperative period, which resolved without consequences. After six months, three patients achieved continuous use of the diaphragm pacing system, and one patient could be removed from mechanical ventilation for more than 4 hours per day. CONCLUSIONS: The implantation of a diaphragmatic phrenic system is a new and safe technique with potential to improve the quality of life of patients who are dependent on mechanical ventilation because of spinal cord injuries. Appropriate indication and adequate perioperative care are fundamental to achieving better results.
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Artigos e Materiais de Revistas Científicas - FM/MCG
Departamento de Cirurgia - FM/MCG

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - FM/MNE
Departamento de Neurologia - FM/MNE

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Instituto do Câncer do Estado de São Paulo - HC/ICESP

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Artigos e Materiais de Revistas Científicas - LIM/61
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica


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