Everything about Diaphragmatic Pacemaker totally explained
A
diaphragmatic pacemaker, in
medicine, is a surgically-implanted device used to help patients
breathe following complications from
spinal cord injuries. The device works through
pacing of the
diaphragm.
Mechanism
In patients with a diaphragmatic pacemaker, their breathing is helped by setting the
respiratory rate by
electrical stimulation (pacing) of the
phrenic nerve. The pacing is accomplished via
electrodes
surgically implanted into the diaphragm, which is controlled by the phrenic nerve.
Diaphragm pacing stimulates a normal breath response as follows: when an
electrical current is passed through the electrodes, the diaphragm contracts, expanding the chest cavity, causing air to be sucked into the
lungs (
inspiration). When the nerve isn't stimulated, the diaphragm relaxes and air moves out of the lungs (
expiration).
Procedure
This procedure is currently experimental. It is being tested in patients with
injuries that cut across (transect) the
cervical spinal cord high in
the neck and result in
paralysis of all four
limbs (
tetraplegia) and
respiratory failure which require constant mechanical ventilatory support. For the procedure to work, the function of the phrenic nerve must be normal.
Diaphragm pacing originally required a surgical opening of the
chest cavity (
thoracotomy) to
implant the electrodes. It is now done by
laparoscopy through small openings in the chest. Patients undergo laparoscopic implantation of electrodes in the
muscle of the diaphragm and initial electrical stimulation. Following a
recovery period of a week or so, diaphragm pacing is initiated.
Wires from the electrodes in the diaphragm run to and from a control box worn outside the body. The pacing is performed according to a reconditioning program in which the duration and
frequency of electrode stimulation is gradually increased until full-time diaphragm pacing is achieved.
The actor
Christopher Reeve, who was
paralyzed and on a
respirator after fracturing his neck in a
horseback riding accident, underwent the procedure in 2003.
Further Information
Get more info on 'Diaphragmatic Pacemaker'.
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