Diaphragm Pacing in Infants and Children: Report of a Simplified Technique and Review of Experience

Diaphragm pacing was used for treating 6 infants with congenital hypoventilation syndrome at the Children's Memorial Hospital, Chicago. All patients had inadequate sleep-related ventilation and absent ventilatory response to hypercarbia. A single incision was utilized to implant both the electrode and receiver. The phrenic nerve was isolated with a piece of pericardium to minimize injury. All infants required bilateral nerve pacing to obtain satisfactory ventilation (normal transcutaneous measurements of partial pressure of oxygen and end-tidal pressure of carbon dioxide). The technical details described here are helpful in achieving successful phrenic nerve pacing in infants with results comparable to those reported in adults.