Breath Synchronized Abdominal Muscle Stimulation to Facilitate Ventilator Weaning: a Pilot Study

Breath Synchronized Abdominal Muscle Stimulation to Facilitate Ventilator Weaning: a Pilot

The primary objective of this study is to determine whether neuromuscular electrical stimulation applied to the abdominal wall muscles in synchrony with exhalation can increase the strength of the respiratory muscles in prolonged mechanical ventilation patients.

In the U.S. over 500,000 patients have difficulty weaning from mechanical ventilation every year. These patients cost the health care system $16 billion annually and have an increased risk of medical complications and morbidity.

A major factor responsible for weaning failure is the imbalance between decreased respiratory muscle strength and excessive respiratory load. This study includes an investigational device that applies electrical stimulation to the abdominal muscles in synchrony with exhalation. This is hypothesized to improve the strength of the respiratory muscles. The long term goal of this project is to determine whether this approach can reduce the number of days taken for patients to wean from mechanical ventilation.

Inclusion Criteria:

• Patients who have been mechanically ventilated for at least fourteen days.
• Clinically stable: oxygen saturation > 90% with a fractional inspired oxygen ≤ 0.40, external positive end expiratory pressure ≤ 5 centimeters water, temperature ranging from 35.5 to 38.5 degrees celsius, no intravenous administration of vasoactive agents.

Exclusion Criteria:

• Patients in whom Neuromuscular Electrical Stimulation (NMES) does not elicit a palpable contraction of the abdominal muscles.
• Patients with broken or irritated skin on the abdominal wall
• Patients with a history of neuromuscular disease
• Body Mass Index (BMI) > 35 kg/m2
• Patients who are not medically stable
• Patients with a pacemaker
• Female patients who are pregnant
• Patients under the age of 18
• Patients who are expected to die within four weeks
• Patients who are unable to follow verbal instructions
• Patients with epilepsy
• Patients with an abdominal wall hernia
• Patients with anoxic encephalopathy
• Patients with history of, or active, substance abuse