Spinal cord injury level and Phrenic Nerve Conduction Studies do not predict diaphragm pacing success or failure- all patients should undergo diagnostic laparoscopy
| العنوان: | Spinal cord injury level and Phrenic Nerve Conduction Studies do not predict diaphragm pacing success or failure- all patients should undergo diagnostic laparoscopy |
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| المؤلفون: | MaryJo Elmo, Bashar Katirji, Cindy Stepien, Raymond P. Onders |
| المصدر: | American journal of surgery. 221(3) |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Diaphragm paralysis, medicine.medical_treatment, Neural Conduction, Phrenic nerve conduction, Diagnostic laparoscopy, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Reaction Time, Medicine, Humans, Spinal cord injury, Spinal Cord Injuries, Retrospective Studies, Mechanical ventilation, Spinal Cord Stimulation, business.industry, 030208 emergency & critical care medicine, General Medicine, medicine.disease, Spinal cord, Methods observational, Respiration, Artificial, Respiratory Paralysis, Phrenic Nerve, Diaphragm pacing, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, Anesthesia, Surgery, Laparoscopy, business |
| الوصف: | Background Diaphragm Pacing(DP) demonstrates benefits over mechanical ventilation(MV) for spinal cord injured(SCI) patients. The hypothesis of this report is that phrenic nerve conduction study(PNCS) results cannot differentiate success or failure in selection of patients for DP. Direct surgical evaluation of the diaphragm should be performed. Methods Observational report of prospective databases of patients undergoing laparoscopic evaluation of their diaphragms to assess for ability to stimulate to cause contraction for ventilation. Results In 50 SCI patients who could not be weaned from MV, PNCS results showed latencies in stimulated patients (n = 44) and non-stimulated(n = 6) overlapped (7.8 ± 2.5 ms vs 9.4 ± 2.8 ms) and the null hypothesis cannot be rejected (p-value>0.05). Amplitudes overlapped (0.4 ± 0.2 mV vs 0.2 ± 0.2 mV) and the null hypotheses cannot be rejected (P-value >0.05). In 125 non SCI patients with diaphragm paralysis, there were 78(62.4%) with false negative PNCS. Conclusion PNCS are inadequate pre-operative studies. Direct laparoscopic evaluation should be offered for all SCI patients to receive the benefit of DP. |
| تدمد: | 1879-1883 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ba61b5b248346e49e0b03f34192d0873 https://pubmed.ncbi.nlm.nih.gov/33243416 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....ba61b5b248346e49e0b03f34192d0873 |
| قاعدة البيانات: | OpenAIRE |
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