Mechanical Ventilation
Conditions
Keywords
electrical stimulation, diaphragmatic, weaning, respiratory muscle
Brief summary
Muscle atrophy and diaphragm dysfunction are common with prolonged mechanical ventilation (PMV). Electrical stimulation has been shown to be beneficial in severe chronic heart failure and chronic obstructive pulmonary disease. However, its effect on PMV is unclear. This study examined the effects of transcutaneous electrical diaphragmatic stimulation (TEDS) on respiratory muscle strength and weaning outcomes in patients with PMV.
Detailed description
Patients on ventilation for ≥21 days were randomly assigned to TEDS and control groups. The TEDS group received muscle electrical stimulation for 30 min/session/day throughout the intervention. Weaning parameters (tidal volume, respiratory rate, and rapid shallow breathing index) and respiratory muscle strength (Pimax, Pemax) were assessed. The hospitalization outcome, including weaning rate and length of stay, was followed up until discharge.
Interventions
DEVICEtranscutaneous electric diaphragm stimulation
The electrodes were placed on the parasternal region beside the xiphoid process; and the sixth and seventh intercostal spaces in line with the mid-axillary line. TEDS was set as biphasic waves, frequency of 30 Hz, pulse width of 400 μs, and rise time of 0.7s.
Sponsors
Chang Gung Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Masking description
Subjects were not informed of the results of allocation
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 20 years; * MV for \> 6 h/day for \> 21 days; * Medical stability (PaO2 ≥ 60 mmHg at 40% FiO2, absence of signs and symptoms of infection, and hemodynamic stability).
Exclusion criteria
* Acute lung or systemic infection, hemodynamic instability, patients with pacemakers, abdominal distention, and pregnancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| respiratory muscle strength (maximal inspiratory pressure) | the 1st day of intervention | pressure gauge |
| tidal volume | 1st day of intervention | The tidal volume was measured by a spirometer |
| rapid shallow breathing index | 1st day of intervention | respiratory rate/tidal volume |
| respiratory muscle strength (maximal expiratory pressure) | the 1st day of intervention | pressure gauge |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| weaning rate | through study completion,an average of 7 weeks | ventilator weaning results (weaning successful/failure) |
| length of stay in respiratory care center | through study completion,an average of 7 weeks | the total days of stay in respiratory care center |
Countries
Taiwan
Outcome results
None listed