The goal of this clinical trial is to learn about in patients with prolong mechanical ventilation. This main questions aims to answer are: * High protein formula intake benefit in successful weaning from ventilator * Core muscle rehabilitation benefit in successful weaning from ventilator * neuromuscular electric stimulation benefit in successful weaning from ventilator Participants will receive high protein diet, core muscle rehabilitation, neuromuscular electric stimulation (NMES). Researchers will compare patients with interventions to control group to see if high protein diet, core muscle rehabilitation, neuromuscular electric stimulation works.
The investigator aims to investigate the efficacy of below list methods in patients with prolong mechanical ventilator: * High protein formula intake benefit in successful weaning from ventilator * Core muscle rehabilitation benefit in successful weaning from ventilator * neuromuscular electric stimulation benefit in successful weaning from ventilator Participants will randomly stratify into four groups: (1) Usual care (UC), (2) UC + high protein diet (HP), (3) UC + HP + core muscle rehabilitation, (4) UC + HP + core muscle rehabilitation + neuromuscular electric stimulation (NMES). Researchers will compare group 2,3,4 to control group (1, usual care) to see if high protein diet, core muscle rehabilitation, neuromuscular electric stimulation works.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
100
The HP groups will maintain unchanged total daily caloric intake and increasing protein content to 1.5g/kg/day.
Core muscle rehabilitation is sitting on bedside with or without aids, for 30 minutes, twice per day, 5 days per week, for 3 weeks
NMES was applied for 30 min, twice per day, 5 days per week, for 3 weeks via surface rectangular electrodes. Electrodes were placed on back designed to activate latissimus dorsi and abdominal wall designed to activate the transversus abdominis and internal and external oblique muscles. Electrical muscle stimulation was performed by using a commercial stimulator (GEMORE, GM300E, Taipei, Taiwan) with biphasic waves at a simulation frequency of 30 Hz and pulse width of 400s, cycling 2s on and 4s off. Electrical muscle stimulation intensity was gradually increased until a visible muscle contraction was observed (median 60 mA \[range 50-65 mA\].
Department of Thoracic Medicine, Chang Gung Memorial Hospital
Taoyuan District, Taiwan
Weaning Rate
weaning success defined as weaning from ventilator for 5 consecutive days
Time frame: 3 months
In Hospital Mortality
through the end of admission, up to 3 months
Time frame: 3 months
Length of Mechanical Ventilator Usage
total ventilator use days in this admission
Time frame: 3 months
Length of ICU Stay
total ICU stay in this admission
Time frame: 6 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.