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Related Experiment Videos

Phrenic nerve injury. A prospective study.

G W Laub1, S Muralidharan, C Chen

  • 1Department of Surgery, Deborah Heart and Lung Center, Browns Mills, NJ 08015.

Chest
|August 1, 1991
PubMed
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This summary is machine-generated.

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Phrenic nerve insulation significantly reduced phrenic nerve injury (PNI) during cardiac surgery. This technique protects the phrenic nerve from iced saline slush, a common cause of PNI, without increasing mortality.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Neurosurgery

Background:

  • Topical iced saline solution slush is used in cardiac surgery to maintain myocardial hypothermia.
  • Phrenic nerve injury (PNI) is a known complication of this hypothermia technique.

Purpose of the Study:

  • To evaluate the impact of phrenic nerve insulation on PNI incidence during cardiac surgery.
  • To determine if insulating the phrenic nerve can reduce its injury rate.

Main Methods:

  • A prospective study comparing a control group (CG) with an intervention group (IG) of 76 patients each undergoing coronary revascularization.
  • The IG received phrenic nerve insulation using a foam pad between the heart and pericardium.

Main Results:

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  • The incidence of roentgenographically diagnosed PNI was significantly higher in the CG (18%) compared to the IG (0%), p = 0.0006.
  • No difference in in-hospital mortality between groups (CG 0.0%, IG 1.3%, p = 1.0).
  • Patients with PNI had a longer postoperative hospital stay (32 vs 11 days, p = 0.04).

    • Conclusions:

    • Routine use of phrenic nerve insulation significantly reduces the incidence of PNI during cardiac surgery.
    • Phrenic nerve insulation is a safe and effective method to prevent PNI without increasing mortality.