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Poster Presentations: Tuesday, November 2, 2010 |

Impact of Diaphragmatic Pacing in Weaning of Critically Ill Spinal Cord Injury Patients FREE TO VIEW

Adriel J. Malave, MD; Muwafaq Alhomsi, MD; Ersin Demirer, MD; Elamin Elamin, MD
Author and Funding Information

University of South Florida, Tampa, FL



Chest. 2010;138(4_MeetingAbstracts):383A. doi:10.1378/chest.9761
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Published online

Abstract

PURPOSE: Diaphragm pacing stimulation (DPS) has been promoted as a mean to provide diaphragm function in ventilator-dependent spinal cord injury (SCI) patients. However, little is known about the changes in pulmonary functions after DPS insertion. This report summarizes the short term changes in pulmonary function post DPS insertion in two SCI patients.

METHODS: We recorded the exhale tidal volume (ETV) and % oxygen saturation (SaO2) while on spontaneous breathing for the two patients prior-to and for four months after the DPS insertion.

RESULTS: The mean age of the two SCI patients was 50± 23 with the mean time between the C-3 SCI and the DPS insertion was 2.75± 0.75 months.There was statistically significant increase in ETV, mean: 352.5± 182 ml, (p< 0.02), in both patients within two months after DPS insertion. Such increase maintained in patient ‘A’ at month ‘4’ since DPS insertion compare to baseline, mean: 548± 22, (p< 0.0003). In addition, there was continued increase in ETV between Month ‘2’ and ‘4’ in the same patient post DPS insertion, though that was statistically insignificant (p< 0.09). However, patient ‘B’ ETV progressively declined after Month #2, with mean ETV on Month ‘4’ of 213 ±25 ml. Such decline was statistically significant when compared with ETV on Month ‘2’, p< 0.0005. Furthermore, the decline in ETV was accompanied with marked decrease in patient ‘B’ SaO2 (96±1 to 83 ±4%, p< 0.007).

CONCLUSION: Diaphragm pacing stimulation (DPS) is an innovative tool in management of patients with SCI. This brief report highlights some of the short term pulmonary changes following DPS insertion with the possibility of declining in ETV post DPS insertion. Such decline in diaphragmatic function can be further investigated by documenting diaphragmatic movements under fluoroscopy and by diaphragmatic Electromyography (EMG).

CLINICAL IMPLICATIONS: DPS as a tool for management of patients with SCI and possible set backs.

DISCLOSURE: Adriel Malave, No Financial Disclosure Information; No Product/Research Disclosure Information

12:45 PM - 2:00 PM


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