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Fundamental Considerations in Pacing of the Diaphragm for Chronic Ventilatory Insufficiency: A Multi-Center Study
Authors:WILLIAM W. L. GLENN  ROBERT T. BROUILLETTE  BEZALEL DENTZ  HARALD FODSTAD  CARL E. HUNT  THOMAS G. KEENS  H. MICHAEL MARSH  SANGAM PANDE  DAVID G. PIEPGRAS  R. GRAHAM VANDERLINDEN
Affiliation:Yale University School of Medicine;Children's Memorial Hospital (Chicago);University of Umea (Sweden);Childrens Hospital of Los Angeles;Mayo Clinic;Toronto Western Hospital
Abstract:Records were reviewed of 477 patients who had diaphragm pacemakers implanted for treatment of chronic hypoventilation. Three groups were established for comparison. (1) Center group: 165 patients operated on in six medical centers participating in a cooperative study; (2) Noncenter group, sufficient data available: 203 patients operated on by surgeons with experience limited to a few cases; (3) Nonstudy group, minimal data available: 109 patients operated on as in group 2; vital statistics only were contributed. The protocol for data gathering was comprised of 154 major variables. Basic data on age, sex, diagnosis and etiology were analyzed for homogenicity of data among the groups. A comprehensive analysis of the pacing methods, complication and results fom the Center group yielded information on the early experience with diaphragm pacing important to its future application.
Keywords:diaphragm    diaphragm pacing    electrical stimulation    hypoventilation    phrenic nerve    ventilatory insufficiency
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