Mechanical Ventilation, Weaning
Conditions
Keywords
phrenic nerve stimulation, diaphragm function
Brief summary
the early application of non-invasive PNS in MV patients can increase the number of days without mechanical ventilation, delay disuse phrenic atrophy, and improve the strength of inspiratory muscle.
Detailed description
A prospective randomized controlled study included 104 patients with MV who met inclusion criteria in multiple hospital ICU units and were randomly divided 1:1 into PNS and conventional groups. The PNS group received neuromuscular electrical stimulation in addition to routine airway management, early activity and respiratory muscle training. It was verified that early non-invasive PNS could increase the number of days without mechanical ventilation for 28 days, delay disused diaphragm atrophy and improve inspiratory muscle strength.
Interventions
DEVICENon-invasive phrenic nerve stimulation
Some studies have shown that PNS can relieve diaphragmatic atrophy and reverse diaphragmatic dysfunction.
Sponsors
Bing Sun
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Masking description
Patients enrolled in the study were unaware of the study
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Age ≥18years and ≤80years; * MV time ≤48h; * MV duration is expected to be ≥72h; * The sternocleidomastoid region and pectoralis major region were completely exposed. * Patients or family members are willing to sign informed consent and participate in the study.
Exclusion criteria
* There are contraindications to PNS in vitro (Pneumothorax, active tuberculosis, pleural adhesions, installation of pacemakers and defibrillators, etc.); * Neuromuscular disease (myasthenia gravis, etc.) or known anatomical abnormalities of the diaphragm; * ECMO status; * Hemodynamic instability; * Uncorrected arrhythmias; * Be pregnant; * Clinical end-stage and palliative care patients.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Ventilator-free days | 28 days |
Secondary
| Measure | Time frame |
|---|---|
| mechanical ventilation days | 28 days |
| re-intubation rate | 28 days |
| ICU mortality | 28 days |
| 60/90-day survival rate | 28 days |
| diaphragm thickening fraction | up to 28 days |
| Transdiaphragmatic Pressure | up to 28 days |
| Maximal Inspiratory Pressure | up to 28 days |
| Diaphragm thickness | up to 28 days |
Other
| Measure | Time frame |
|---|---|
| The incidence of adverse events | up to 28 days |
| Medical expenses | through study completion, an average of 30 days |
Countries
China
Contacts
Primary ContactLi Wang, B.S.Nurs
Backup ContactBing Sun, MD
Outcome results
None listed