Abstract
Background:
Diaphragm dysfunction is one of common complication in patients with prolong mechanical ventilator (PMV) and is often associated with increased rate of weaning failure and days of hospitalization. Electrical stimulation (ES) has been shown to be beneficial in the improvement of muscle strength in patients with COPD. The purpose of this study is to examine the acute effects of transcutaneous electric diaphragmatic stimulation (TEDS) on pulmonary function in patients with PMV.
Methods:
Patients who have been ventilated for >21 d were recruited from respiratory care center. Subjects were randomly assigned into TEDS group (n=12) or control group (n=11). The TEDS group received muscle electrical stimulation for 30 min/session. Before and after intervention, subjects were assessed weaning parameters (tidal volume [VT], minute volume [MV], breathing frequency [f], and rapid shallow breathing index [RSBI]) and respiratory muscle strength. The vital sign during intervention was also recorded. This study was approved by the Institutional Review Board of Chang Gung Memorial Hospital (201700096A3). A Wilcoxon rank signed test was used to examine the effects of the interventions on weaning parameters within group.
Results:
There was no significant difference at pre-measurements (0 min) between TEDS and control groups. After 30 min TEDS, subjects in TEDS group have significant improvement in VT (391.0 (343.0-459.0) mL vs 444.0 (344.0-485.0) mL, P<0.05), whereas no significant changes was found in control group (346.0 (330.0-460.0) mL vs 380.0 (341.0-471.0) mL, p>0.05). In TEDS group, subjects demonstrated no significant changes in HR (82.0 (74.0-94.0) breaths/min vs 82.0 (69.0-97.0 breaths/min, p>0.05) and blood pressure (systemic blood pressure: 129.0 (110.0-148.0) vs 132.0 (116.0-147.0 mm Hg), p>0.05).
Conclusions:
In patients with PMV, the application of TEDS results in a immediately increase f tidal volume. This application did not induce any significant changes of vital sign and may consider as one of the supplement treatment for ventilated patients who has diaphragm dysfunction.
HR: heart rate; SBP: systolic blood pressure; DBP: diastolic blood pressure; RR: respiratory rate; Vt: tidal volume; MV: minute volume; RSBI: rapid shallow breathing index. *: 30 min vs 0 min, p<0.05 View all access options for this article.Table. Acute effect of ES on vital sign and pulmonary mechanics
TEDS group
Control group
0 min
30 min
0 min
30 min
HR (bpm)
82.0(74.0-94.0)
82.0(69.0-97.0)
77.0(68.0-84.0)
75.0(67.0-80.0)
SBP(mmHg)
129.0(110.0-148.0)
132.0(116.0-147.0)
138.0(119.0-148.0)
130.0(98.0-153.0)
DBP(mmHg)
64.0(58.0-73.0)
64.0(58.0-73.0)
64.0(54.0 -77.0)
54.0(46.0-65.0) *
Compliance(ml/cmH2O)
43.0(32.0-54.2)
42.0(33.0-54.0)
32.0(28.6-56.0)
32.0(29.0-53.0)
Resistance(cmH2O)
14.0(12.0-16.3)
15.0(12.0-16.4)
15.0(14.0-23.0)
16.0(15.0-21.0)
RR(bpm)
19.0(15.0-21.0)
18.0(14.0-22.0)
20.0(17.0-26.0)
16.0(15.0-21.0)
Vt (ml)
391.0(343.0-459.0)
444.0(344.0-485.0)*
346.0(330.0-460.0)
380.0(341.0-471.0)
MV (L)
6.87(5.92-9.04)
7.01(6.13-8.95)
7.10(6.41-9.22)
6.12(5.70-8.76)
SpO2(%)
98.0(97.0-100.0)
98.0(96.0-100.0)
98.0(97.0-100.0)
98.0(96.0-99.0)
RSBI
102.0(54.0-125.0)
105.5(56.9-138.0
99.0(63.0-126.0)
107.0( 99.5-135.0)
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