ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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Diaphragmatic Paralysis And Pacing: Review
Dr. Sedat GÜRKÖK,a Dr. Onur GENÇa
aGöğüs Cerrahisi AD, GATA, ANKARA
One of the most essential respiratory muscles is the diaphragm, which is innervated by cervical motor neurons C3-4-5 via the phrenic nerve. Diaphragmatic paralysis can involve either the entire diaphragm (bilateral) or only one leaflet (unilateral).
Most patients with unilateral diaphragmatic paralysis are asymptomatic and do not require treatment. Diaphragmatic plication can be considered in patients with dyspnea disproportionate to the degree of physical activity or severity of lung disease.
Treatment depends on the etiology and severity of paralysis in bilateral paralysis. Diaphragmatic pacing by electrical stimulation of the phrenic nerve facilitates treatment of selected forms of respiratory failure. This procedure involves the placement of an electrode and a receiver with an external transmitter. Indications for diaphragmatic pacing are ventilator-dependent patients with high cervical cord injury, and those with central alveolar hypoventilation.
We review examples of such patients with diaphragmatic paralysis and discuss treatment options. We outline the prerequisites for diaphragm pacing and procedures of surgical implantation.Keywords: Diaphragmatic paralysis, electrical stimulationTurkiye Klinikleri J Med Sci 2005, 25:111-117
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