New Delhi: For 53 year old Satpal Singh from Meerut, the word freedom connotes riddance from ventilator and breathing naturally. As India celebrates its 73 rd independence day, his freedom from ventilator has just begun, thanks to ground breaking diaphragmatic pacing technique. Mr Singh has been tethered to ventilator for the last 4 years for every puff of air. After successful surgery for the pacing of diaphragm on July 26 in Indian Spinal Injuries Centre (ISIC), he has started breathing naturally. Dr H S Chahbra, Medical Director cum Chief of Spine at ISIC said to this writer that for now he is breathing naturally for one hour only but 5-6 months later, he will achieve complete freedom from mechanical breathing. Satpal received a bullet injury in the third vertebrae in the cervical spine (C3) and was on ventilator ever since. ISIC is the first medical facility that has introduced this technique in India. Like Satpal, for thousands of paralytic patients strapped to ventilator, this technique is manna from heaven. Given its huge potential in India, All India Institute of Medical Sciences (AIIMS) has evinced great interest in this technique. This technique is hugely useful in ICU. Late Christopher Reeve, the American actor who played Superman, paralysed and on ventilator, also got diaphragmatic pacemaker to breathe naturally.
ISIC, India’s leading spinal injury treatment facility, has tied up with Leading American Gastrointestinal Surgeon, Dr Raymond P Onders, to introduce a program of the path-breaking procedure of Diaphragmatic Pacing in India. The procedure pioneered by Dr Onders enables ventilator-free breathing in paralyzed patients dependent on a ventilator support. Patients who are partially or fully paralyzed due to spinal injury or neuromuscular illnesses sometimes need the help of assisted breathing devices or mechanical ventilator. Such patients can benefit enormously by diaphragmatic pacing that can help improve the patient’s natural breathing performance and potentially stop their
dependence on a mechanical ventilator. Diaphragm pacing is a minimally invasive procedure to allow ventilator-free breathing for patients paralyzed due to spinal injury and can decrease invasive mechanical ventilation in intensive care units. By artificially stimulating the diaphragm to contract, we enable the patient to breathe naturally without the help of a ventilator. The diaphragm pacing system acts as a rehabilitative tool and allows patients to reduce their dependence on a ventilator or even eliminate the patient’s need for artificial breathing support. I am glad to help doctors at Indian Spinal Injuries Centre to acquire the ability to perform this procedure that will benefit hundreds of patients. The procedure involves implanting electrodes into the patient’s diaphragm muscle and connecting them to an external stimulator which sends electrical impulses. This stimulation to the muscles and
nerves of the diaphragm causes it to contract and helps the patient breathe without the help of a mechanical ventilator.
Dr Chhabra said, ‘Patients paralyzed due to high cervical spinal cord or non-respiratory conditions including traumatic brain injury or neuromuscular illnesses like cannot breathe on their own because the nerves and muscles of their diaphragm become dysfunctional. They have to depend on assistive breathing devices or ventilator support.
Diaphragm pacing procedure involves artificially stimulating the diaphragm to enable the patient breathes normally. It can reduce or completely eliminate the patient’s dependence on ventilator support.’