Multichannel stimulation of phrenic nerves by epineural electrodes. Clinical experience and future developments.

摘要: Between 1983 and 1992, 23 patients with complete ventilatory insufficiency of differing etiologies were treated an eight channel implant (Medimplant Inc., Vienna) for fatigue free stimulation both phrenic nerves. Data 15 high spinal cord lesions (ages: 9-51 years) are summarized: 1) level lesion: C0, 3 patients; C1/C2, 4; C2/C3, 8; 2) time between incident implantation: 3-14 months; 3) diaphragm training: 1-22 4) chronic pacing: 5-83 5) tracheostomy closed: 7 6) living permanently at home: 13 7) respiratory rate per minute: 12-17; 8) duration inspiration: 1.0-1.3 sec; 9) tidal volume: 7-20 ml/kg body weight; 10) volume 121-198 11) pH: 7.39-7.42; 12) pCO2: 22.9-38.6 mmHg; 13) pO2: 81.2-104.5 14) died by December 4 patients. All currently available implants pacing need external power supply radio control. The authors have developed tested the first fully implantable device. Features this include electronic circuit based on microcontroller MC68HC705C8; surface mounted technology (SMD); channels; constant current source adjustable to 5 mA in 256 steps, impulse duration: 100-1000 musec, frequency: 1-33 Hz; minimum lifetime: years. is programmed via bidirectional transmission using IBM compatible computer. dimensions, including battery, electrode connectors, antenna, 67 x 48 mm. weights 58 g. This new device may improve patients' safety quality life near future.