Pulmonary capacity of patients with total traumatic injury of the brachial plexus submitted to neurotization with the phrenic nerve: a case series.

Camila Fernandes de Melo, Armèle Dornelas de Andrade, Fernando Henrique Souza, Helen Kerlen Bastos Fuzari, Juliana Fernandes, Silvya Nery Bernardino, Daniella Araújo de Oliveira


Total traumatic injury often requires surgical intervention such as neurotization using the phrenic nerve with the aim to recover the elbow function. However, its repercussions on the respiratory kinematics are unknown. Objective: To  valuate the ribcage volume in tricompartments division, kinematics of Duty Cycle, and shortening velocity of the respiratory muscles after nerve phrenic transfer. Methods: Five participants (4 male), aged 18 to 40 years old (32±2), diagnosed with total brachial plexus injury and with nerve phrenic transfer. The optoelectronic plethysmography (OEP) was the instrument to evaluate volume in quiet breathing (QB), inspiratory capacity (IC) and vital capacity (VC) of the rib cage in its tricompartments division (pulmonary rib cage, abdominal rib cage and abdomen rib cage) and in each hemithorax, as well as the shortening velocity of the respiratory muscles, and respiratory rate. Assessments occurred 30 days prior and 30 days after surgery. Results: There was a decrease in the total compartmental distribution in QB with statistical difference only in the abdominal compartment (p <0.05). Four patients showed a reduction in the shortening speed of the left diaphragm muscle. It was not possible to perform a group analysis of respiratory kinematics and volumes in CV, IC due to the variation found in each patient analyzed. Conclusion: There was a reduction in volume in the rib cage as well as a change in the speed of shortening of the respiratory muscles after the transfer of the phrenic nerve one month after surgery.



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