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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.
Subjects on ventilation for ≥21 days were randomly assigned to TEDS or control groups. The TEDS group received muscle electrical stimulation for 30 min/session/day throughout the intervention. Weaning parameters 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 |
|---|---|---|---|
| transcutaneous electrical diaphragmatic stimulation (TEDS) | Experimental | Subjects received daily TEDS (30min/day, 5days/week ) until the end of the weaning trial. During TEDS, rectangular electrodes were placed on the parasternal region beside the xiphoid process; the sixth and seventh intercostal spaces in line with the mid-axillary line. TEDS was performed by applying biphasic waves at a stimulation frequency of 30 Hz, pulse width of 400 μs. TEDS intensity was gradually increased until visible muscle contraction was observed. Each session lasts for 30 min day. |
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| Control group | No Intervention | Subjects in the control group did not received TEDS program. Subjects in the control group received the same pre- and post-measurement as those in TEDS group. The control group received medical treatment as those in TEDS group. The pulmonary function was measured at the beginning and end of the intervention. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TEDS | Device | An non-invasive intervention. During the intervention, the electrode was placed on the skin stimulated muscle. |
|
| Measure | Description | Time Frame |
|---|---|---|
| breathing frequency | The pulmonary function as assessed by the measurement of respiratory rate | through study completion, an average of 2 weeks |
| Pimax | The pulmonary function as assessed by the measurement of max inspiratory pressure | through study completion, an average of 2 weeks |
| Vt | The pulmonary function as assessed by the measurement of tidal volume | through study completion, an average of 2 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| RCC days | The total days that participants stay in the respiratory care center | through study completion, an average of 6 weeks |
| weaning rate | the status of ventilator use |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yen-Huey Chen, PhD | Chang Gung University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dept of Respiratory therapy, Chang Gung University | Taoyuan | 333 | Taiwan |
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| through study completion, an average of 6 weeks |