ELECTRICAL-STIMULATION TO RESTORE RESPIRATION

Electrical stimulation has been used for over 25 years to restore brea thing to patients with high quadriplegia causing respiratory paralysis and patients with central alveolar hypoventilation, Three groups have developed electrical pacing systems for long-term support of respirat ion in humans, These systems consist of electrodes implanted on the ph renic nerves, connected by leads to a stimulator implanted under the s kin, and powered and controlled from a battery-powered transmitter out side the body. The systems differ principally in the electrode design and stimulation waveform. Approximately 1,000 people worldwide have re ceived one of the three phrenic pacing devices, most with strongly pos itive results: reduced risk of tracheal problems and chronic infection , the ability to speak and smell more normally, reduced risk of accide ntal interruption of respiration, greater independence, and reduced co sts and time for ventilatory care. For patients with partial lesions o f the phrenic nerves, intercostal muscle stimulation may supplement re spiration.