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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2002 June;68(6):567-71
The phrenic nerve stimulator, a valid ventilatory support in the management of quadriplegic patients receiving home health care services. A case report
Giglio A. M., Rovella C., Botindari E., Alba M.
Ospedale dei Bambini «G. Di Cristina» - Palermo Servizio di Anestesia e Rianimazione Pediatrica
The authors describe the case of a quadriplegic child with post-traumatic respiratory insufficiency and total dependency on mechanical ventilation. The child was a long-term inpatient at the Pediatric Intensive Care Unit of Palermo. Considering the patient’s long life expectancy, psychological distress and determination of the patient and family members to have the patient at home again, the plan for dehospitalization included the use of a phrenic stimulator as a supplement to conventional mechanical ventilation that would simplify home health care and improve the patient’s quality of life. Electromyography, fluoroscopy and gas analysis were conducted to evaluate whether the patient was physically fit to receive a stimulator. The device was then implanted at the Spinal Cord Injury Treatment Unit in Sondalo. The stimulator is compact in design, operates silently, and affords more natural ventilation without interfering with breathing rhythm, and maintains muscle trophism. In combination with mechanical ventilation, the pacing device is an ideal system for home respiratory assistance. Additional benefits include increased patient mobility outside the home and improved quality of life. The system provides good respiration, as shown by EtCO2 and SpO2 measurements and long-term monitoring performed at our unit.