J Med Assoc Thai 2009; 92 (12):1691

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Phrenic Nerve Stimulation for Diaphragmatic Pacing in a Patient with High Cervical Spinal Cord Injury
Sitthinamsuwan B Mail, Nunta-aree S

Background: Phrenic nerve stimulation is a therapeutic option for patients with central hypoventilation
syndrome due to brain stem and high cervical spinal cord dysfunction.

Case Report:
A 28-year old woman with high cervical spinal cord injury at the level of C2 had chronic central
hypoventilation syndrome, requiring long-term use of a home ventilator. Preoperative end tidal CO2 and
tidal volume during spontaneous breathing indicated hypoventilation syndrome. Bilateral phrenic nerve
stimulation for diaphragmatic pacing was performed with spinal cord stimulators used for chronic pain. The
end tidal CO2 pressure (ETCO2 ), tidal volume, and spontaneous breathing time have improved up to 29
months of postoperative follow-up period.

Conclusion: Phrenic nerve stimulation for diaphragmatic pacing can reduce all-time requirement of
ventilatory support in patients with high cervical spinal cord injury.

Keywords:
Central hypoventilation syndrome, Phrenic nerve stimulation

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