Phrenic nerve stimulation for diaphragmatic pacing in chronic ventilator-dependent patients

Clinical and fluoroscopic recording [Figure 2] and [Video 1], [Video 2] was made of robust diaphragmatic contractions with cyclic monopolar stimulation of up to 2 mAmp, 50 Hz, 100 μs pulse width parameters with the NIM-Eclipse Nerve Stimulator System (Medtronic, MN, USA). The end-tidal carbon dioxide pressure was adjusted to about 400 mm Hg by changing the output strength of the implantable pulse generator (IPG) with continuous monitoring of the same and oxygen saturation levels. [6]{Table 1} For chronic ventilator-dependent patients with central hypoventilation, diaphragmatic pacing by phrenic nerve stimulation is a viable last resort to wean them off ventilator, thereby facilitating ambulation, physiotherapy, and psychosocial improvement.