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Electrophrenic pacing and decannulation for high-level spinal cord injury: a case series

Authors:	Bolikal Priya Bach John R Goncalves Miguel

Institution:	Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, University Hospital, Newark, NJ 07103, USA.

Abstract:	Background In 1997, guidelines were developed for the management of high-level ventilator-dependent patients with spinal cord injury who had little or no ventilator-free breathing ability (VFBA). This article describes the three categories of patients, the decannulation criteria, and the successful decannulation of four patients with no VFBA and electrophrenic/diaphragm pacing, using these criteria. Method Case series. Conclusion Lack of VFBA in patients with high-level spinal cord injury does not mandate tracheostomy or electrophrenic/diaphragm pacing.

Keywords:	Glossopharyngeal breathing Assisted cough Mechanical insufflation–exsufflation Spinal cord injuries Tetraplegia Respiratory therapy Noninvasive mechanical ventilation Electrophrenic pacing Diaphragm pacing
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