Clinical Rehabilitation

 

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Clinical Rehabilitation, Vol. 5, No. 3, 215-218 (1991)
DOI: 10.1177/026921559100500307

The rehabilitation of a ventilator dependent child using diaphragmatic stimulation

RM Stephens

Portsmouth Polytechnic

DR Potter

King's College Hospital, London

ER Howard

King's College Hospital, London

R. Hallett

St Mary's Hospital, Portsmouth

The rehabilitation of a male child who remained tetraplegic and ventilator dependent after Haemophilus influenzae meningitis at the age of 18 months is described. Diaphragm pacing, per phrenic electrical stimulation of the diaphragm, has been used in the USA, but at the time only one patient had been managed with this technique in the UK. Successful rehabilitation of this adult patient at King's College Hospital prompted the application of the technique to the child here described. At the age of 34 months the integrity of the phrenic nerves had been confirmed, and bilateral phrenic electrodes and pacing receivers were implanted. The patient is now 12 years old, and has been using diaphragm pacing for nine years. His rehabilitation, social integration, and education have relied on this method of artificial ventilation, the advantages and disadvantages of which are described.


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