Improved arterial oxygenation by diaphragmatic pacing in quadriplegia

Despite increased alveolar ventilation, positive-pressure ventilation (PPV) reproducibly resulted in less efficient arterial oxygenation as compared to diaphragmatic pacing in a quadriplegic patient with respiratory paralysis. Volume loading acutely restored arterial oxygenation during PPV. This report emphasizes the important interaction between the cardiovascular and pulmonary systems in effecting gas exchange, particularly in quadriplegics. In this respect, diaphragmatic pacing seems to perform better than PPV.