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  • Title: [Patients with high spinal cord injuries: evaluation of diaphragmatic function, indication of electrophrenic ventilation].
    Author: Brule JF, Leriche B, Normand J, Morel P.
    Journal: Agressologie; 1993; 34 Spec No 2():90-2. PubMed ID: 7802153.
    Abstract:
    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.
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