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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TEDS | Experimental | Subjects received transcutaneous electrical diaphragm stimulation (TEDS) for 30min/ day till the end of the weaning trial |
|
| Control | No Intervention | Subjects received similar medical treatment except for the TEDS program. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| transcutaneous electric diaphragm stimulation | Device | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| tidal volume | The tidal volume was measured by a spirometer | 1st day of intervention |
| tidal volume | The tidal volume was measured by a spirometer | through study completion,an average of 4 weeks |
| rapid shallow breathing index | respiratory rate/tidal volume | 1st day of intervention |
| rapid shallow breathing index | respiratory rate/tidal volume | through study completion,an average of 4 weeks |
| respiratory muscle strength (maximal inspiratory pressure) | pressure gauge | the 1st day of intervention |
| respiratory muscle strength (maximal expiratory pressure) | pressure gauge | the 1st day of intervention |
| respiratory muscle strength (maximal inspiratory pressure) | pressure gauge | through study completion,an average of 4 weeks |
| respiratory muscle strength (maximal expiratory pressure) | pressure gauge | through study completion,an average of 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| weaning rate | ventilator weaning results (weaning successful/failure) | through study completion,an average of 7 weeks |
| length of stay in respiratory care center | the total days of stay in respiratory care center |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yi-Fei Hsin | Chang Gung Memorial Hospital | Principal Investigator |
| Yen-Huey Chen | Chang Gung University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chang Gung University | Taoyuan City | Tao-Yuan | 333 | Taiwan |
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Subjects were not informed of the results of allocation
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| through study completion,an average of 7 weeks |