Effects of Neuromuscular Electrical Stimulation on Critically Ill Patients With Mechanical Ventilation
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Respiratory Insufficiency Requiring Mechanical Ventilation
- Sponsor
- The Affiliated Hospital of Qingdao University
- Enrollment
- 47
- Locations
- 1
- Primary Endpoint
- diaphragmatic thickening fraction(DTF)
- Last Updated
- 4 years ago
Overview
Brief Summary
Up to 25% of patients who require mechanical ventilation (MV) more than seven days in the intensive care unit (ICU) develop muscle weakness, which comprises deep muscle weakness , including the respiratory muscles.Early active mobilization in ICU patients is a safe and viable strategy to prevent the physical problems caused by immobility. Neuromuscular electrical stimulation (NMES) is an alternative to mobilize and exercise because it does not require active patient participation and can be used on bedridden patients.No previous studies have shown whether training-specific respiratory muscles using an electrical stimulation can have overall benefits for ICU patients on MV.For this reason, the aim of this study was to evaluate, the effectiveness of the NMES therapy combined with early rehabilitation in the respiratory muscles of patients on MV.
Investigators
JinyanXing
Director
The Affiliated Hospital of Qingdao University
Eligibility Criteria
Inclusion Criteria
- •Prolonged MV(\>72 h);
- •Written informed consent was obtained from the patients or their relatives
Exclusion Criteria
- •Previous neuromuscular disease;
- •Unrelieved pneumothorax, restricted diaphragmatic dyskinesia including abdominal high pressure, a large number of ascites
- •Thoracic or diaphragmatic malformation;
- •Local skin damage and infection;
- •Indwelling a temporary or permanent pacemaker;
- •Severe obesity(BMI\>35 kg/m2)
- •Various reasons (severe intestinal gas accumulation, structural abnormalities) lead to the failure of ultrasonic detection of diaphragm movement;
- •Patients with an expected survival time of less than 7 days or with palliative care
Outcomes
Primary Outcomes
diaphragmatic thickening fraction(DTF)
Time Frame: baseline,Day 3 of mechanical ventilation,Day 7 of mechanical ventilation,before extubation
DTF shows varied thickness of the diaphragm at end-expiration and end-inspiration. Te maximum and minimum values of each breathing cycle were taken as the end-inspiratory diaphragm thickness (DTei) and the end-expiratory diaphragm thickness (DTee), respectively. DTF was calculated by DTF=(DTei DTee)/DTee 100%. Te values for 3 consecutive respiratory cycles were recorded and the average value was taken as the fnal value
Secondary Outcomes
- Parasternal Intercostal Muscle Ultrasound(baseline,Day 3 of mechanical ventilation,Day 7 of mechanical ventilation,before extubation)