Biology of the neonate
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Over the last 26 years diaphragm pacing has been used in over 400 adults and 70 children to support ventilation and oxygenation. Diaphragm pacing can be useful for conditions in which the brain stem respiratory centers provide little or no stimulation to the respiratory muscles, i.e. central hypoventilation syndrome, Arnold-Chiari malformation/brain stem dysfunction, and high quadriplegia. Because the pacing systems are so portable, the greatest advantages accrue to those patients who require ventilatory support both while awake and asleep. ⋯ Mean time to failure was 56 months. Of our 36 patients who had diaphragm pacing systems implanted, 26 are alive and 22 are currently using the pacing systems. wo recent advances may further improve the long-term outcome of patients using diaphragm pacing. Smaller, better encapsulated receivers may improve system longevity and a new stimulus electrode may reduce the risk of diaphragmatic damage.