Breathing on their own - Research summary

BACKGROUND: As many as 450,000 Americans are living with a spinal cord injury (SCI). Every year, it's estimated that 11,000 SCIs occur in the United States. Most SCIs are caused by trauma to the vertebral column, affecting the spinal cord's ability to send and receive messages from the brain to the body's systems that control sensory, motor and autonomic function below the level of injury. According to the CDC, spinal cord injuries cost about $9.7 billion every year. The incidence of SCIs is highest among persons age 16 to 30 (53.1%). The three leading causes of SCI's include auto accidents, falls and gunshots (Source: National Spinal Cord Injury Association).



CAUSES: Paralysis is the complete loss of muscle function for one or more muscle groups. It can cause loss of feeling or loss of mobility in the affected area. Paralysis is most often caused by damage to the nervous system, especially the spinal cord. Major causes are stroke, trauma, poliomyelitis, amyotrophic lateral sclerosis (ALS), botulism, spina bifida, multiple sclerosis and Guillain-Barre syndrome. The inability to breathe on one's own occurs when a person is injured high in their neck. The cervical nerve, number three, number four, and number five form to make the nerve called the phrenic nerve, and that goes to the diaphragm on either side, which allows people to breathe. About 70 percent of a person's breathing comes from the diaphragm.



TRADITIONAL VENTILATORS: Traditional ventilators are large machines which limit mobility and create a dependency on a power source. Because a ventilator is a high-pressure system, it causes a lot of pressure to the lungs. Being attached to tubes carries the risk of other complications. The tubes can harbor bacteria and mucous. In addition, there is an increased risk for getting acquired pneumonia.



DIAPHRAGM PACING SYSTEM: The diaphragm pacing system (DPS) is a lightweight and battery powered alternative to a ventilator. The DPS is a unit about the size of a large remote and is worn externally by the patient and connected to wires that exit the chest. The implanted electrodes act as a pacing device and electrically stimulate the muscle sheet across the rib cage, causing the diaphragm to contract, just as it would for people with normal connections between the brain and muscles. The procedure to implant the device involves surgical implantation of electrodes, via laparoscopic surgery, to stimulate the phrenic nerve, the motor innervation to the diaphragm that is responsible for the act of breathing.



Most individuals with serious paralysis are unable to breathe on their own and traditionally relied on ventilators. The DPS stimulates the diaphragm muscle, allowing them to breathe and speak more naturally. The DPS also has the potential to drop the infection rates and trauma on patients' lungs over time. Because the DPS is surgically implanted, it makes it easier for a person to become more independent and decrease their dependency on traditional ventilators. Other benefits include increased olfactory sensation, greater social interaction, more participation in rehabilitation activities and improved occupational opportunities.



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