Diaphragmatic pacing for high cervical cord injury 

Introduction

 

Phrenic nerve and direct diaphragm pacing are technologies that have been approved for use as a viable alternative to long-term mechanical ventilation in suitable patients.

 

Benefits of diaphragmatic pacing include:

- reducing respiratory secretions

- reduced hospital length of stay

- improved quality of speech

- regained sense of taste and olfaction

- ease of eating and drinking

- overall improved quality of life

 

 

Potential surgical candidates need to be carefully screened and to meet specific criteria. Patients need to be free of chest wall deformity and be medically stable, and these techniques are only suitable for patients with viable phrenic nerves. Cervical spine injury patients with damage to phrenic nerve nuclei at C3-5 segmental levels may not be able to benefit from this technology.

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Connie and Ho Gai are Hong Kong's first two diaphragmatic pacemaker recipients

Through the generous donation from Chow Tai Fook Charities Foundation, HKU O&T launched its pilot program on direct diaphragmatic pacemaker insertion in Hong Kong. The surgeries were performed in August 2019 for an acute SCI patient (one month post-injury) and a chronic SCI patient (10 years post-injury). Both patients are currently fully weaned from mechanical ventilation. These are the first two surgeries in Hong Kong and greater China.