부산대학교 도서관

The phrenic nerve innervates the diaphragm, the major muscle involved in the inspiratory phase (breathing in) of respiration. Damage to this nerve can result in impaired respiratory function; total damage on both sides can cause asphyxiation unless the patient is maintained on a respirator. Phrenic nerve injury is a known complication of cardiac surgery; studies have reported phrenic nerve injury in between 0.5 and 2.2 percent of pediatric cardiac surgery. This estimate may be low, because criteria used for determination of phrenic nerve damage were difficulty in weaning the patient from the ventilator and similar, relatively insensitive indices of nerve function. To more accurately determine the prevalence and duration of phrenic nerve injury in pediatric cardiac surgery patients, 50 infants and 50 children under the age of 15 were evaluated with respect to phrenic nerve function before and after cardiac surgery. Determination of nerve function was made by electrically stimulating the phrenic nerve through the skin and recording the evoked electromyographic potentials at the diaphragm. Ten patients (10 percent), six under the age of one year, developed phrenic nerve injury on one side (as determined by a delay or abolition of the evoked diaphragmatic response). In patients under one year of age, the damage was accompanied by a prolonged recovery period, because of difficulty in resuming spontaneous respiration. The incidence of phrenic nerve injury was not related to the type of operation, the experience of the surgeon, the duration of the operation, or the age of the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)