PMC6786381_01
Diaphragm Pacing System. Left panel: External stimulator (a), patient cable (b), and connector with skin badge (c). Right panel: Pacing system connected to the exiting portion of the electrode wires (d)
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Fig1
Intraoperative stimulation has demonstrated response and benefit from placement even when surface electrodiagnostics have not shown diaphragmatic innervation.(4) She was taken to the operating room on hospital day 21 for laparoscopic diaphragm mapping and pacer (Fig. 1) (NeuRx, Synapse Biomedical) implantation as previously described in children with slight modification.
Continuous diaphragm EMG showing background cardiac activity. The left diaphragm (upper trace with apnea event noted*) and right diaphragm (lower trace with absent motor units)
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Fig2
An episode of apnea was captured (Fig. 2).
Electromyography of the left (upper trace) and right (lower trace) hemidiaphragms under spontaneous respiration. Gain 200 muV/div, sweep 50 ms/div
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Fig3
On the right, there were no motor units, consistent with complete denervation (Fig. 3).