Surgery
Volume 148, Issue 4 , Pages 893-898 , October 2010

Multicenter analysis of diaphragm pacing in tetraplegics with cardiac pacemakers: Positive implications for ventilator weaning in intensive care units

Presented at Central Surgical 2010, March 10–13, 2010, Chicago, Illinois.

  • Raymond P. Onders, MD

      Affiliations

    • Department of Surgery, University Hospitals Case Medical Center, Cleveland, OH
    • Corresponding Author InformationReprint requests: Raymond P. Onders, MD, Department of Surgery, 11100 Euclid Avenue, Cleveland, OH 44106.
    • ,
  • Saeid Khansarinia, MD

      Affiliations

    • Department of Thoracic Surgery, Piedmont Hospital, Atlanta, GA
    • ,
  • Todd Weiser, MD

      Affiliations

    • Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, NY
    • ,
  • Cynthia Chin, MD

      Affiliations

    • Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, NY
    • ,
  • Eric Hungness, MD

      Affiliations

    • Department of Surgery, Northwestern University, Chicago, IL
    • ,
  • Nathaniel Soper, MD

      Affiliations

    • Department of Surgery, Northwestern University, Chicago, IL
    • ,
  • Alberto DeHoyos, MD

      Affiliations

    • Department of Surgery, Northwestern University, Chicago, IL
    • ,
  • Tim Cole, MD

      Affiliations

    • Department of Surgery, Saint Elizabeth Regional Medical Center, Lincoln, NE
    • ,
  • Christopher Ducko, MD

      Affiliations

    • Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA

References 

  1. Devivo MJ, Go BK, Jackson AB. Overview of the national spinal cord injury statistical center database. J Spinal Cord Med. 2002;25:335–338
  2. Spinal Cord Injury Information Network Website. Available from: http://www.spinalcord.uab.edu. Accessed February 14, 2010.
  3. Ruiz-Arango A, Robinson V, Sharma G. Characteristics of patients with cervical spinal injury requiring permanent pacemaker implantation. Cardiol Rev. 2006;14:8–11
  4. Franga D, Hawkins M, Medeiros R, et al. Recurrent asystole resulting from high cervical spinal cord injuries. Ann Thorac Surg. 1998;66:1698–1704
  5. Bilello JF, Davis JW, Cunningham MA, Groom TF, Lemaster D, Sue LP. Cervical spinal cord injury and the need for cardiovascular interventions. Arch Surg. 2003;138:1127–1129
  6. Onders RP, Ignagni AI, Aiyer H, Mortimer JT. Mapping the phrenic nerve motor point: the key to a successful laparoscopic diaphragm pacing system in the first human series. Surgery. 2004;136:819–826
  7. Onders R, DiMarco A, Ignagni A, Mortimer J. The learning curve for investigational surgery: lessons learned from laparoscopic diaphragm pacing for chronic ventilator dependence. Surg Endosc. 2005;9:633–637
  8. Onders RP, Elmo MJ, Ignagni AR. Diaphragm pacing stimulation system for tetraplegia in individuals injured during childhood or adolescence. J Spinal Cord Med. 2007;30:25–29
  9. Onders RP, Elmo M, Khansarinia S, Bowman B, Yee J, Road J, et al. Complete Worldwide Experience in laparoscopic diaphragm pacing: results and differences in spinal cord injured patients and amyotrophic lateral sclerosis patients. Surg Endosc. 2009;23:1433–1440
  10. Adler D, Gonzalez-Bermejo J, Duguet A, Demoule A, Le Pimpec-Barthes F, Hurbault A, et al. Diaphragm pacing restores olfaction in tetraplegia. Eur Respir J. 2009;34:365–370
  11. Hirshfield S, Exner G, Luukkaala T, Baer GA. Mechanic ventilation or phrenic nerve stimulation for treatment of spinal cord-induced respiratory insufficiency. Spinal Cord. 2008;1–5
  12. Zhan C, Baine W, Sedrakyan A, Steiner C. Cardiac device implantation in the united states from 1997 through 2004: a population-based analysis. J Gen Intern Med. 2008;23:13–19
  13. Onders RP, Calin AM, Elmo MJ, Sivashankaran S, Katirji B, Schilz R. Amyotrophic lateral sclerosis: the Midwestern Surgical experience with diaphragm pacing stimulation system shows that general anesthesia can be safely performed. Am J Surg. 2009;197:386–390
  14. Zilberberg M, Wit M, Pirone J, Shore AF. Growth in adult prolonged acute mechanical ventilation: implications for healthcare delivery. Crit Care Med. 2008;36:1451–1455
  15. Powers S, Kavazis A, Levine S. Prolonged mechanical ventilation alters diaphragmatic structure and function. Crit Care Med. 2009;37:347–353
  16. Levine S, Nguyen T, Taylor N, Friscia ME, Budak MT, Rothenberg P, et al. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Engl J Med. 2008;35:1327–1335
  17. Onders R, McGee M, Marks J, Chak A, Schilz R, Rosen M, et al. Diaphragm pacing with natural orifice transluminal endoscopic surgery (NOTES): potential for difficult to wean intensive care unit (ICU) patients. Surg Endosc. 2007;21:475–479

 Case Western Reserve University, Dr Raymond Onders, and University Hospitals Case Medical Center have intellectual property rights involved with the diaphragm pacing system and equity in Synapse Biomedical who manufactures the device.

PII: S0039-6060(10)00370-3

doi: 10.1016/j.surg.2010.07.008

Surgery
Volume 148, Issue 4 , Pages 893-898 , October 2010

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