In an upcoming edition of the Journal Spinal Cord, and published in advance online, physicians at the BG-Trauma in Hamburg, Germany report that "PNS instead of MV for treatment of SCI-RDD reduces RIs, running costs of respiratory treatment, and obviously improves patients' quality of life."

"Permanent respiratory device dependency (RDD) due to cervical spinal cord injury (SCI) traditionally is treated with different kinds of mechanical ventilation (MV). However, electroventilation has become a choice again..."

"By using the mechanical energy of the patient’s diaphragm, the patient is freed from the ventilator tube, the tracheostoma and with his helpers from the bulky energy supply of mechanical ventilators (MVs)."

"No patient with normal phrenic nerves and diaphragm muscles wanted MV."

"We think the striking difference in RI between patients on PNS and MV is due to the different use of the tracheostoma. With MV, coughing is impossible, and the tube is frequently opened for suctioning. With PNS the tracheostoma is omitted or the tube is plugged, which makes active, though weak coughing possible and suctioning unnecessary."

"Treatment of respiratory insufficiency after cervical SCI witha PNS instead of MV

(1) significantly reduces upper airway infections,
(2) reduces costs for single use airway equipment,
(3) improves the quality of speech,
(4) obviously improves patients’ quality of life,
(5) probably reduces mortality and prolongs life,
(6) 1 and 2 together pay off the higher primary investment with PNS during the first year after start of use of PNS."

Hirschfeld S, Exner G, Luukkaala T, Baer GA. "Mechanical Ventilation or Phrenic Nerve Stimulation for Treatment of Spinal Cord Injury-Induced Respiratory Insufficiency" Spinal Cord; pp 1-5, E-Pub May 2008.