Thoracoscopic placement of phrenic nerve pacers for diaphragm pacing in congenital central hypoventilation syndrome

Kristina J. Nicholson, Lauren B. Nosanov, Kanika Bowen-Jallow, Sheila S. Kun, Iris A. Perez, Thomas G. Keens, Cathy E. Shin

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: Congenital central hypoventilation syndrome (CCHS), or Ondine's curse, is a rare disorder affecting central respiratory drive. Patients with this disorder fail to ventilate adequately and require lifelong ventilatory support. Diaphragm pacing is a form of ventilatory support which can improve mobility and/or remove the tracheostomy fromCCHS patients. Little is known about complications and long-termoutcomes of this procedure. Methods: A single-center retrospective review was performed of CCHS patients undergoing placement of phrenic nerve electrodes for diaphragm pacing between 2000 and 2012. Data abstracted from the medical record included operation duration, ventilationmethod, number of trocars required, and postoperative and pacing outcomes. Results: Charts of eighteen patients were reviewed. Mean surgical time was 3.3 ± 0.7 hours. In all cases except one, three trocars were utilized for each hemithorax, with no conversions to open procedures. Five patients (27.8%) experienced postoperative complications. The mean ICU stay was 4.3±0.5 days, and the mean hospital stay is 5.7±0.3 days. Eleven patients (61.1%) achieved their daily goal pacing times within the follow-up period. Conclusions: Thoracoscopic placement of phrenic nerve electrodes for diaphragmatic pacing is a safe and effective treatmentmodality for CCHS. Observed complications were temporary, and the majority of patientswere able to achieve pacing goals.

Original languageEnglish (US)
Pages (from-to)78-81
Number of pages4
JournalJournal of Pediatric Surgery
Volume50
Issue number1
DOIs
StatePublished - 2015
Externally publishedYes

Fingerprint

Phrenic Nerve
Diaphragm
Surgical Instruments
Electrodes
Conversion to Open Surgery
Tracheostomy
Operative Time
Medical Records
Congenital central hypoventilation syndrome
Length of Stay

Keywords

  • Congenital central hypoventilation syndrome
  • Diaphragmatic pacing
  • Ondine's curse
  • Phrenic nerve electrodes

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Thoracoscopic placement of phrenic nerve pacers for diaphragm pacing in congenital central hypoventilation syndrome. / Nicholson, Kristina J.; Nosanov, Lauren B.; Bowen-Jallow, Kanika; Kun, Sheila S.; Perez, Iris A.; Keens, Thomas G.; Shin, Cathy E.

In: Journal of Pediatric Surgery, Vol. 50, No. 1, 2015, p. 78-81.

Research output: Contribution to journalArticle

Nicholson, Kristina J. ; Nosanov, Lauren B. ; Bowen-Jallow, Kanika ; Kun, Sheila S. ; Perez, Iris A. ; Keens, Thomas G. ; Shin, Cathy E. / Thoracoscopic placement of phrenic nerve pacers for diaphragm pacing in congenital central hypoventilation syndrome. In: Journal of Pediatric Surgery. 2015 ; Vol. 50, No. 1. pp. 78-81.
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AU - Perez, Iris A.

AU - Keens, Thomas G.

AU - Shin, Cathy E.

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AB - Purpose: Congenital central hypoventilation syndrome (CCHS), or Ondine's curse, is a rare disorder affecting central respiratory drive. Patients with this disorder fail to ventilate adequately and require lifelong ventilatory support. Diaphragm pacing is a form of ventilatory support which can improve mobility and/or remove the tracheostomy fromCCHS patients. Little is known about complications and long-termoutcomes of this procedure. Methods: A single-center retrospective review was performed of CCHS patients undergoing placement of phrenic nerve electrodes for diaphragm pacing between 2000 and 2012. Data abstracted from the medical record included operation duration, ventilationmethod, number of trocars required, and postoperative and pacing outcomes. Results: Charts of eighteen patients were reviewed. Mean surgical time was 3.3 ± 0.7 hours. In all cases except one, three trocars were utilized for each hemithorax, with no conversions to open procedures. Five patients (27.8%) experienced postoperative complications. The mean ICU stay was 4.3±0.5 days, and the mean hospital stay is 5.7±0.3 days. Eleven patients (61.1%) achieved their daily goal pacing times within the follow-up period. Conclusions: Thoracoscopic placement of phrenic nerve electrodes for diaphragmatic pacing is a safe and effective treatmentmodality for CCHS. Observed complications were temporary, and the majority of patientswere able to achieve pacing goals.

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