It has been known for years that electrical current can stimulate nerves. Electrical stimulation of the phrenic nerve to move the diaphragm and produce a breathing response (electrophrenic respiration or EPR) was investigated in the 1930s and the studies were intensified during the polio epidemics of the 1940s and 1950s. The phrenic nerve was stimulated both by direct application of electrodes to the nerve and by use of external electrodes. Technical problems were solved, however, only when modern cardiac pacemakers and microelectronic science appeared. Contemporary electrophrenic respiration devices have been used successfully in persons suffering from central ventilation problems such as Ondine's curse, Pickwickian syndrome, encephalitis, and cervical cord lesions. Varying voltage applied to the phrenic nerve, unilaterally or bilaterally, can control tidal volume by diaphragmatic motion, thus correcting blood oxygen and carbon dioxide. Future devices probably will be smaller, and perhaps computerized EPR units will someday be able to automatically adjust ventilation according to respiratory needs.
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