All are true about bilateral diaphragmatic paralysis, except: (AIIMS May 2008)
|A||Sniff test is positive|
|B||Causes normocapnic failure|
|C||Diaphragmatic pacing is useful if phrenic nerve is intact|
|D||None of the above|
Causes normocapnic failure
1). "Most patients with severe diaphragmatic weakness present with hypercapnic respiratory failure
2). Sniff test is a confirmatory test of unilateral diaphragmatic paralysis. (The person is asked to sniff and is observed with fluoroscopy. The paralyzed diaphragm moves paradoxically upwards during inhalation due to negative intrathoracic pressure.) ·
3). Diaphragmatic pacing may be a viable alternative if the nerve to the diaphragm is intact.
4). Treatment of choice for Bilateral Diaphragmatic Paralysis is assisted ventilation
1). Unilateral paralysis occurs due to more local cause e.g. nerve invasion from bronchogenic carcinoma. Patients are usually asymptomatic.
2). Bilateral paralysis occurs due to more central or generalized causes e.g. high spinal cord injury, muscular dystrophy) chest trauma.