COPD (Chronic Obstructive Pulmonary Disease), Diaphragm Electrical Activity
Conditions
Keywords
chronic obstructive pulmonary disease exacerbation, Electrical diaphragmatic stimulation
Brief summary
Respiratory muscle dysfunction is a common consequence of chronic obstructive pulmonary disease (COPD). This technique consists of placing electrodes on the skin at locations near the motor points of the diaphragm, transmitting an intermittent current, and generating action potentials capable of producing muscle contractions
Detailed description
Respiratory muscle dysfunction is a common consequence of chronic obstructive pulmonary disease (COPD).Weakness or fatigue of the diaphragm and accessory muscles of inspiration is widely recognized in patients on mechanical ventilation. There is increasing evidence to show mechanical ventilation itself may adversely affect the diaphragm's structure and function, which has been termed ventilator-induced diaphragmatic dysfunction. However, in patients with more severe COPD, the benefits of rehabilitation may be limited. In this context, there are new approaches to PR, such as electrical stimulation, a technique that externally stimulates contractions of peripheral muscles to improve peripheral muscle function in patients with severe COPD. This technique consists of placing electrodes on the skin at locations near the motor points of the diaphragm, transmitting an intermittent current, and generating action potentials capable of producing muscle contractions
Interventions
TEDS group will be subjected to sessions of TEDS as follow : Digital electrical muscle stimulator (EV-906 Digital TENS/EMS made in TAIWAN) is applied to induce diaphragm contraction.
Sponsors
Study design
Masking description
Participants will be randomly assigned into a TEDS group or control group. Method of randomization : Before participant recruitment, sequential sealed envelopes are prepared by an independent investigator, with one envelope will be chosen randomly by another investigator for each participant.
Intervention model description
Effect of trans-cutenuous electrical diaphragmatic stimulation on severe chronic obstructive pulmonary disease exacerbation
Eligibility
Inclusion criteria
* Age \>18 years. * Known cases of COPD admitted at respiratory critical care unit with severe acute exacerbation (defined according to GOLD 2024).
Exclusion criteria
* Body mass index (BMI) \> 35 kg/m2 * Post arrest patients * Brain death * Hemodynamic instability * Invasive MV * Lung disease other than COPD * Pregnancy , ascitis. * History of neuromuscular disease at admission * Spinal injuries * Skin lesions or an open lesion in the regions where the electrodes would be placed * Use of pacemakers * Patients on maintenance steroid therapy * Depletating disease as malignancy 14. Patients refusing the procedure
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The primary outcome is the progression to invasive mechanical ventilation(IMV) | 6 months | Functional assessment by US measurement of diaphragmatic excursion and thickness fraction in (cm) including base line measurement and post treatment measurement ( at the end of admission). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The secondary outcomes is the duration of ICU admission | 12 months | The secondary outcomes is the duration of ICU admission (days), the immediate effect of TEDS and after sessions. |
Countries
Egypt
Contacts
Lecturer of chest medicine faculty of medicine Mansoura university