A recent survey of phrenic nerve stimulators from Australia noted a high incidence of revision operations (42%). Complications in this cohort (not necessarily due to the stimulators themselves) included “recurrent respiratory tract infections, urinary tract infections, pressure sores, kyphoscoliosis, neurogenic bladder and muscle spasms“.
Phrenic nerve damage may occur at the time of surgery, or later as the result of mechanical injury or fibrosis. Cervical electrodes may lead to mechanical tension and injury during neck motion. The rate of postoperative infection is 1–2%. Battery failure is a common cause of mechanical failure. Negative intra-thoracic pressure causes paradoxical (inward) movement of the upper chest and results in negative work. This is not a problem in adults however in children this may reduce inspired volumes, as their chest walls are much more compliant.
Phrenic Nerve Stimulators: Side Effects/Problems
- Reoperation: 42%
- Phrenic nerve damage
- Post-operative infection (1-2%)
- Paradoxical movement / negative work
- Associated problems: respiratory tract infections, UTI, pressure sores, kyphoscoliosis, neurogenic bladder and muscle spasms
Peter Khong, Amanda Lazzaro, Ralph Mobbs Phrenic nerve stimulation: the Australian experience. J Clin Neurosci: 2010, 17(2);205-8
Anthony F DiMarco Phrenic nerve stimulation in patients with spinal cord injury. Respir Physiol Neurobiol: 2009, 169(2);200-9