Total Ventilatory Support in a Quadriplegic Patient with Radiofrequency Electrophrenic Respiration

Abstract

A patient with respiratory paralysis from injury of the cervical cord was freed from dependence upon a mechanical respirator through the use of electrical stimulation of both phrenic nerves. This was accomplished with radiofrequency transmission to two radio receiver electrode assemblies implanted subcutaneously 14 months ago. By forceful contractions of his unparalyzed neck muscles the patient is able to assist ventilation voluntarily but is unable to support adequate ventilation by voluntary effort alone for more than a few minutes. Total ventilatory support by radiofrequency electrophrenic respiration has been maintained for more than 11 months. The two sides of the diaphragm are stimulated alternately for periods of 12 hours. Normal tidal volume and blood gas concentration with the patient in the recumbent position have been demonstrated. The tracheostomy tube has been removed; the patient can speak, and he has resumed some normal activities.