{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T11:25:25Z","timestamp":1778498725522,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T00:00:00Z","timestamp":1646697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cervical spinal cord injury (SCI) can lead to dependence on mechanical ventilation (MV) with significant morbidity and mortality. The diaphragm pacing system (DPS) was developed as an alternative to MV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective single\u2010arm study of DPS in MV\u2010dependent patients with high SCI and intact phrenic nerves. Following device acclimation, pacing effectiveness to provide ventilation was evaluated. The primary endpoint was the number who could use DPS to breathe for 4 continuous hours without MV. Secondary endpoints included the number of patients that could use DPS 24\u00a0h\/day free of MV and the ability of DPS to maintain clinically acceptable tidal volume (Vt). In addition, we conducted a meta\u2010analysis that included the prospective study along with data from four recently published studies to evaluate DPS hourly use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010three patients were implanted in the prospective study. Most were male (77.4%) with a median time from injury to treatment of 28.3 (IQR: 12.1, 83.3) months. Four\u2010 and 24\u2010h use occurred in 96.2% (95% CI: 87.0%, 99.5%) and 58.5% (95% CI: 44.1%, 74.9%), respectively. Four and 24\u2010h results in the meta\u2010analysis cohort (<jats:italic>n<\/jats:italic>\u00a0=\u00a0196) exhibited similar results 92.2% (95% CI: 82.6%, 96.7%) and 52.7% (95% CI: 36.2%, 68.6%) using DPS for 4 and 24\u00a0h, respectively. DPS use significantly exceeded the calculated basal tidal volume requirements by a mean of 48.4% (95% CI: 37.0, 59.9%; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrates that in most ventilator\u2010dependent patients, diaphragm pacing can effectively supplement or completely replace the need for MV and support basal metabolic requirements.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14221","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T14:08:28Z","timestamp":1646057308000},"page":"1980-1987","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Diaphragm pacing in spinal cord injury can significantly decrease mechanical ventilation in multicenter prospective evaluation"],"prefix":"10.1111","volume":"46","author":[{"given":"Raymond P.","family":"Onders","sequence":"first","affiliation":[{"name":"Department of Surgery University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeid","family":"Khansarinia","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Thoracic Surgery Piedmont Hospital  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e1ll E.","family":"Ingvarsson","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation Landsp\u00edtali \u2013 The University Hospital of Iceland  Reykjav\u00edk Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Road","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Department of Medicine The University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Yee","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Department of Medicine The University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Dunkin","sequence":"additional","affiliation":[{"name":"Department of Surgery Houston Methodist Hospital  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony R.","family":"Ignagni","sequence":"additional","affiliation":[{"name":"Synapse Biomedical, Inc.  Oberlin Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2762-0"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/168757"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v6.i1.17"},{"key":"e_1_2_8_5_1","unstructured":"National Spinal Cord Injury Statistical Center.The 2020 Annual Statistical Report for the Spinal Cord Injury Model Systems;2020. 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