1.1
Use phrenic nerve pacing as an option to treat ventilator-dependent high cervical spinal cord injury (SCI) with standard arrangements in place for clinical governance, consent and audit.
Phrenic nerve pacing for ventilator-dependent high cervical spinal cord injury
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1 Draft recommendations
1.2
For auditing the outcomes of this procedure, the main efficacy and safety outcomes identified in this guidance can be entered into NICE's interventional procedure outcomes audit tool (for use at local discretion).
1.3
Patient selection should be done by a multidisciplinary team experienced in managing the condition in specialist centres.
1.4
This procedure should only be done in specialist centres by clinicians with specific training and experience in the procedure.
Why the committee made these recommendations
The evidence for this procedure shows benefits, such as increased ventilator-free time, reduced respiratory infections and living longer. People with high cervical SCI have multiple comorbidities and their quality of life is often limited. This procedure only treats 1 part of a very complex condition, so the benefits of the procedure are limited. The evidence does not raise any major safety concerns. So, phrenic nerve pacing is recommended.
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