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Updated: May 24, 2026

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Published on: February 23, 2015
Electrophrenic pacing and decannulation for high-level spinal cord injury: a case series
Priya Bolikal1, John R Bach, Miguel Goncalves
1Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, University Hospital, Newark, NJ 07103, USA.
Background:
In 1997, guidelines were developed for the management of high-level ventilator-dependent patients with spinal cord injury who had little or no ventilator-free breathing ability (VFBA). This article describes the three categories of patients, the decannulation criteria, and the successful decannulation of four patients with no VFBA and electrophrenic/diaphragm pacing, using these criteria.
Method:
Case series.
Conclusion:
Lack of VFBA in patients with high-level spinal cord injury does not mandate tracheostomy or electrophrenic/diaphragm pacing.
