Ventilator dependence resulting from a spinal cord injury (SCI) is a dramatic life limiting consequence. By controlling contraction of the diaphragm with diaphragm pacing, however, it has been shown that ventilator dependence in the adult SCI patient can be replaced. Here we present the first pediatric case of diaphragm pacer placement in a 10 year old quadriplegic male.

Using a laparoscopic approach, a Diaphragm Pacing System (Synapse Biomedical, Cleveland, OH) was implanted. A pair of diaphragm stimulating electrodes was placed in each hemidiaphragm. All 4 electrodes were then tested and tunneled out through the skin for attachment to an external pacer.

The child tolerated the procedure well without complication. He was gradually weaned off the ventilator over the following month and transitioned to full pacer support. Feedback from the family was overwhelmingly positive reporting improved voice strength and increased ease in transfer and travel.

Diaphragm pacing could play a large role in improving the quality of life of ventilator dependent pediatric patients with spinal cord injuries. It can allow these children to travel and participate in activities that are not possible while they are requiring continuous ventilator support.