Article

Phrenic nerve pacing is a method of respiratory support that can
replace mechanical ventilation in high-level cervical spinal cord injury patients
with diaphragmatic paralysis. Our objective was to evaluate survival and
long-term quality of life in patients with external respiratory support by PNP vs
volumetric respirator in patients with severe respiratory insufficiency due to a
high-level spinal cord injury.Design:This is a retrospective review study of a
prospectively collected database for evaluate the survival and a questionnaire
for quality of life has been collected face-to-face or by telephone at
present.Patients:Cervical SCI patients with permanent respiratory support (PNP or
MV).Methods:Long-term evaluation of a cohort of PNP-supported patients. We
performed a comparison between these patients and volumetric respirator-supported
patients. For survival analysis, we used the Kaplan-Meier method and Cox
proportional hazards model. The health-related quality of life was assessed with
SF-36 questionnaire, a general HRQL evaluation.Results:One hundred twenty six
patients on permanent respiratory support were evaluated during the study period.
Of these, 38 were on PNP and 88 were mechanically ventilated. Paced patients were
younger and had a longer survival, but in a multivariate analysis adjusted for
age using a multiple logistic correlation we found that length of survival was
greater for PNP patients. In terms of HRQL, the PNP-supported patients showed
better results in terms of social functioning.Conclusions:PNP is a stable and
effective method of long-term respiratory support in this type of patients (SCI
patients dependent on external respiratory support). In these patients it
improves the length of survival and some social issues by quality of life when
compared with patients under MV.

Langue : ANGLAIS