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Lung diseases

Phrenic Damage During Surgery

05/12/2010

Question:

My sister had surgery to remove some nodes( gramulomas) by her lung and during surgery the phrenic never was irritated. Now she is on a ventilator in ICU. She is having a hard time being weaned from it. What if anything can the doctors do to help this processes. She has diabetes and a pace maker on her heart. She is 58 and over weight. They just diagnosed her with Scarcoidosis.

Answer:

Injury to the left phrenic nerve can occur during surgery.  Damage to the nerve can result in paralysis (or no movement of the diaphragm) or paresis (a weakened diaphragm).  Some function may return over time but there is no way to predict the return of function.  Diaphragmatic EMGs can test the nerve and muscle function but do not predict if function will improve.    

There are many other reasons why a patient may have difficulty weaning from a ventilator after surgery.  This can include heart problems, too much fluid, infections, obesity and lung problems.  It is important to make sure that none of these other factors are contributing to her difficulty weaning from the ventilator.

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Response by:

Nitin Y Bhatt, MD Nitin Y Bhatt, MD
Clinical Assisstant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University