PC3060: Breathe Again: Benefit of Diaphragm Pacing in Children with Spinal Cord Injury

Background: Diaphragm pacing is an FDA approved ventilation strategy for adults with spinal cord injury and ALS. There is minimal documentation of its use in children. In this series we will describe the utilization of the NeuRx diaphragm pacer for respiratory support in children by reporting hospital stay, readmission, cost and avoidance of tracheostomy. We hypothesized that this can lead to avoidance of tracheostomy and decreased healthcare costs

Methods: A retrospective review was performed at OSF Healthcare Children’s Hospital of Illinois from June 1, 2017 through October 31, 2021. All children underwent diagnostic laparoscopy (n=7), and had the NeuRx Diaphragm Pacing System™ mapped and implanted. Hospital and demographic data were evaluated comparing diaphragm paced children and a control group of similar age treated with tracheostomy. The paced group was 75% male with ages ranging from 0 to 12 years old, and the control group was 55% male with ages ranging from 0 to 17 years old.

Results: There was a significant difference between the initial length of stay between paced and trached children (156 days vs 83 days), readmissions (6.3 vs 2), and total cost between groups ($596,397.51 vs. $353,691.03).

Conclusion: Diaphragm pacing can be utilized in children with spinal cord injuries and respiratory failure. The children in this series did not require tracheostomy or home ventilator support. Additional benefits include decreased length of stay and health care costs. Future studies are needed to evaluate the long term success of diaphragm pacing.