the BRAIN - Shepherd Center

PacingSystemFeature
Breathing
NeuRx Diaphragmatic Pacing System
gives ventilator-dependent patients hope
for an improved quality of life.
By Bill Sanders
For Jenny Sorenson, not having a voice with which to speak
meant it was hard to have a voice in how she would raise her
children, how she would keep friends informed, and how
she would thank her husband for his faithful support.
Thanks to new technology being implemented at Shepherd
Center, Jenny – and other patients who are dependent upon
a ventilator to make them breathe – can now wean off the
ventilator and instead use an implantable device called the
NeuRx Diaphragmatic Pacing System (DPS). The system
has made all the difference in the world for Jenny, who no
longer has to rely upon her friends and family to read her
lips.“They had gotten pretty good at it,” she says. “But that
wasn’t a solution long-term.”
Now, Jenny uses the NeuRx DPS most of the time, but
still relies upon a ventilator occasionally. Dual dependency is
normal for a while, but eventually, Jenny expects the ventilator
to be a thing of the past in her life.
The NeuRx DPS, which was developed by researchers at
Case Western Reserve University and is licensed by Synapse
Biomedical Inc., works like this: Four small wires are surgically
attached to the diaphragm, the breathing muscle in the
chest. This procedure requires minimally invasive laparoscopic
surgery. These wires exit the chest wall and are attached to an
external stimulator, the NeuRx DPS. The stimulator provides
electrical stimulation through the wires to the diaphragm and
nerves that run through the diaphragm. When stimulated, the
diaphragm contracts, mimicking natural breathing. Air is allowed
to fill the upper and lower parts of the lungs rather than
forcing air in with a mechanical ventilator.
Following clinical trials of NeuRx DPS in patients at
Shepherd Center and elsewhere, the FDA approved the use of
the device in June 2008. After that approval, Jenny was the first
patient in the nation to undergo the procedure and begin using
the pacing system, says Cathy Gragg, the Shepherd program
coordinator for NeuRx DPS. Since then, Shepherd Center
physicians have implanted the device in 10 patients with spinal
cord injury (SCI). Most are now in various stages of weaning
from the ventilator.
Jenny’s success with the NeuRx DPS stems from
determination and hard work on her part, as well as her
caregivers, which include family members. She has come a long
way since the diagnosis of the medical condition that left her a
quadriplegic in early 2008. Doctors at Johns Hopkins Hospital
in Baltimore determined there was an abnormal tangle of
vessels in Jenny’s spinal cord, which cut off blood supply to her
cord. She underwent surgery and transferred to Shepherd for
rehabilitation in May 2008.
While she was undergoing rehabilitation, Andrew Zadoff,
M.D., medical director of Shepherd’s Intensive Care Unit (ICU)
and Pulmonary Services, screened Jenny as a potential candidate
for the NeuRx DPS.
“I had been at Shepherd for two months, and Johns Hopkins
before that, so when they first suggested the pacing system, I just
wanted to go home and see my family,” Jenny recalls. “But after
getting home and clearing my head a little, I realized I really
needed to do this.
“For the first four months on the ventilator, all I did was lie in
bed,” Jenny says. “I didn’t speak clearly with a voice until I got to
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