Effect of Early Non-invasive Phrenic Nerve Stimulation on Weaning in Mechanically Ventilated Patients

Effect of Early Non-invasive Phrenic Nerve Stimulation on Weaning in Mechanically Ventilated Patients：A Multicenter, Randomized Controlled Study

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.

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.

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.