This study aims to examine efficacy of transcutaneous electrical phrenic nerve stimulation (TEPNS) in ventilator-induced diaphragmatic dysfunction (VIDD). The investigators recruit VIDD patients, and randomly assign the patients into TEPNS group and control group. TEPNS group receives TEPNS twice a day for consecutive 5 days. Control group only receives usual care. The investigators collect diaphragm function indicators and outcomes to evaluate the efficacy.
Ventilator-induced diaphragmatic dysfunction (VIDD) is common in intensive care unit (ICU). There is a need of measurements to improve VIDD. The investigators hypothesize that transcutaneous electrical phrenic nerve stimulation (TEPNS) will increase diaphragmatic function. This study is a single centre, randomized controlled trial with control or treatment group in a 1:1 ratio. Eligible patients include aged ≥ 18 years, ventilated for at least 48 h with an expected stay of more than 7 days in the ICU, and diaphragm thickening fraction (DTF)\< 25%. The patients are randomly allocated to either receiveTEPNS and usual care (TEPNS group) or usual care only (control group). Blind is not used. TEPNS is conducted twice a day for consecutive 5 days. Electrodes are applied to bilateral neck skin which phrenic nerve runs underneath. Clinical data are collected, including baseline characteristics, airway pressure, esophageal pressure, gastric pressure, ventilation days, ICU length of stay, 28-day mortality, etc.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
TEPNS is conducted twice a day for consecutive 5 days. Electrodes are applied to bilateral neck skin which phrenic nerve runs underneath.
Peking University Third Hospital
Beijing, Beijing Municipality, China
RECRUITINGTransdiaphragmatic pressure (Pdi)
Pdi=gastric pressure - esophageal pressure
Time frame: Collected once a day after transcutaneous electrical phrenic nerve stimulation (TEPNS) for consecutive 5 days
Airway pressure, esophageal pressure, gastric pressure, airway occlusion pressure, driving pressure, transpulmonary pressure
Determined from respiratory mechanics indicators provided by ventilator or calculated from them
Time frame: Collected once a day after TEPNS for consecutive 5 days
Esophageal pressure-time product
Determined from respiratory mechanics indicators provided by ventilator
Time frame: Collected once a day after TEPNS for consecutive 5 days
Ventilation days
Mechanical ventilation days in 28 days after enrollment
Time frame: Collected at 28 days after enrollment
Length of ICU stay
Days of ICU stay in 28 days after enrollment
Time frame: Collected at 28 days after enrollment
28-day mortality
Survival outcomes
Time frame: Collected at 28 days after enrollment
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