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Point/Counterpoint Editorials |

Counterpoint: Should Phrenic Nerve Stimulation Be the Treatment of Choice for Spinal Cord Injury? NoPhrenic Nerve Stimulation? No

Peter C. Gay, MD, FCCP
Author and Funding Information

From the Mayo Clinic.

Correspondence to: Peter C. Gay, MD, FCCP, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail: pgay@mayo.edu


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

The data in this article were presented in a pro-vs-con debate at CHEST 2011; October 22-26, 2011; Honolulu, HI.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(5):1203-1206. doi:10.1378/chest.13-0219
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The incidence of long-term ventilator assistance in patients with spinal cord injury (SCI) has increased from 1990, rising to 43,700 cases per year in 1998 likely because of better available treatment plans.1 More than $8 billion per year is spent on SCI care in the United States after the first year of injury, and respiratory complications comprise the number one cause of morbidity and mortality in SCI.2 The majority of patients with SCI are male, aged <30 years, and, as expected, the leading causes of death are pneumonia, pulmonary emboli, and septicemia. As of February 2011, the National Spinal Cord Injury Statistical Center3 estimated that 232,000 to 316,000 patients in the United States are living with SCI. Of the 12,000 new cases per year, >2,700 patients with tetraplegia will require extended ventilator support. Ultimately, 2,000 will wean from ventilators, and 500 high tetraplegic injuries will result in permanent mechanical ventilator dependency.

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