Critically ill patients
Conditions
Interventions
Experimental group:Electrophysiologically guided external diaphragmatic pacing
Control group:External diaphragmatic pacing
Sponsors
Zhongda Hospital, Affiliated to Southeast University
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1: Aged 18 to 75 years old 2: Mechanical ventilation time > 24h, and expected to continue mechanical ventilation time > 5 days 3: RASS score =1 point and stable vital signs (inhaled oxygen concentration FiO2=60%, respiratory rate RR=35 times /min, heart rate HR=120/min, systolic blood pressure 90-160mmHg, SpO2=90%) 4: All patients or their families have informed consent and signed an informed consent form
Exclusion criteria
Exclusion criteria: 1: There are clear contraindications to the use of EDP, such as cardiac implantable pacemaker, pneumothorax, etc. 2: Incomplete neck skin, catheterization through internal jugular vein, and untreated internal jugular vein thrombosis 3: Unclear ultrasound imaging, such as obesity (BMI=40 kg/m2) 4: The conduction of phrenic nerve indicated that the stimulation current was > 50mA when diaphragm CMAP did not elicit or elicited waveforms after phrenic nerve stimulation 5: Neuromuscular disorders that are currently being treated with neuromuscular blockade or that affect respiratory muscles 6: The patient may survive for less than 72h due to his own disease; 7: Patients with tumor or pregnancy 8: Patients voluntarily withdraw
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Diaphragm thickening fraction;Diaphragm movement; | — |
Secondary
| Measure | Time frame |
|---|---|
| Time to weaning;Neuroelectrophysiological detection;Success rate/survival rate of weaning within 28 days;IMS score;MRC score;Arterial blood gas analysis; | — |
Countries
China
Contacts
Public ContactZhengyong Hu
Zhongda Hospital, Affiliated to Southeast University
Outcome results
None listed