Electrophysiologic evaluation of phrenic nerves in severe respiratory insufficiency requiring mechanical ventilation

S. S. Moorthy, O. N. Markand, Y. Mahomed, J. W. Brown

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Diaphragmatic paralysis in patients with respiratory insufficiency compounds the problems in the management. In the presence of lower lobe atelectasis, pleural effusion, or a patient's poor respiratory effort, fluoroscopic examination is often not a reliable way to diagnose diaphragmatic paralysis. We observed that transcutaneous phrenic nerve stimulation in the neck and recording the diaphragmatic potentials from electrodes placed on the lower part of the chest is a simple, reliable, and noninvasive technique to diagnose diaphragmatic dysfunction at the bedside in critically ill patients. In 14 postoperative patients and one with cervical spinal cord injury with respiratory failure, we found ten patients who showed phrenic nerve dysfunction. Besides diagnostic utility, the electrophysiologic evaluation of phrenic-diaphragmatic function provides critical information needed for therapy.

Original languageEnglish (US)
Pages (from-to)211-214
Number of pages4
JournalChest
Volume88
Issue number2
DOIs
StatePublished - Jan 1 1985

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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