ArticleAME case reports2025
Long term diaphragmatic electrical stimulation: a case report of three cases illustrating the positive aspects and pitfalls in high spinal injury.
Article in AME case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Diaphragmatic electrical stimulation (DES) describes the process whereby electrical impulses are delivered to the diaphragm or phrenic nerves to elicit diaphragmatic contraction. DES is also known as diaphragmatic pacing, phrenic pacing, electrophrenic respiration or electroventilation. DES may be used as an alternative to positive pressure ventilation in selected patients with high spinal cord injury (SCI) or central hypoventilation syndromes (CHS). By enabling a more physiological form of respiration, it can allow speech, improve olfaction, decrease the frequency of respiratory infections, and ultimately it may improve both the duration and quality of patients' lives. Case Description: This case report provides an overview of the use of DES in 3 patients, one with diaphragmatic intramuscular electrodes and 2 with phrenic nerve stimulation (PNS) leads. We provide details of our assessment strategy prior to implantation and videos of the expected diaphragmatic descent and flow diversion created in a ventilated patient with a single twitch stimulus. Within two months of implantation, our first patient had measurably improved speech in addition to periods of ventilator independence. Our second and third patients were successfully weaned from the ventilator within 6 months. Staffing and safety concerns have mandated a return to overnight mechanical ventilation for both patients. Despite this, liberation from the ventilator and its ancillary tubing has yielded improvements in quality of life and a reduction in the frequency of respiratory infections over the past 4 years for both patients. Conclusions: The patients in this case report derived significant benefit from DES, however, the lack of physiological responsiveness, particularly in quadriplegic patients, and the open loop design requiring repeated manual adjustment are ongoing issues. These systems require external components and frequent battery changes due to high energy demands. Those interested in this technology should expect a steep learning curve. Despite these limitations, with careful patient selection, DES has the potential to make a positive contribution to each patient's quality of life.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.