Intramuscular diaphragm stimulation for ventilator-dependent chronic respiratory failure from high spinal cord injuries
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3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 6 sources, which was discussed by the committee. The evidence included 1 prospective single-arm trial and meta-analysis of 5 studies, 3 retrospective case series, 1 systematic review and 1 case report. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: improved quality of life and number of ventilator-free hours.
3.3 The professional experts and the committee considered the key safety outcomes to be: pain, pneumonia, electrode insertion site infection, electrode breakage, device failure and survival.
3.4 Patient commentary was sought but none was received.
Committee comments
3.5 The committee noted that the procedure can interfere with cardiac pacemakers.
3.6 The committee was informed that the device currently used for this procedure is not MRI compatible.
3.7 The committee noted that this procedure is likely to be suitable for only a small number of people.
Tom Clutton-Brock
Chair, interventional procedures advisory committee
January 2023
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