Effects of transcutaneous electrical diaphragmatic stimulation on respiratory function in patients with prolonged mechanical ventilation

Yi-Fei Hsin; Shu-Hsin Chen; Teng-Jen Yu; Chung-Chi Huang; Yen-Huey Chen

doi:10.4103/atm.atm_158_21

Effects of transcutaneous electrical diaphragmatic stimulation on respiratory function in patients with prolonged mechanical ventilation

Ann Thorac Med. 2022 Jan-Mar;17(1):14-20. doi: 10.4103/atm.atm_158_21. Epub 2022 Jan 14.

Authors

Yi-Fei Hsin¹, Shu-Hsin Chen¹, Teng-Jen Yu¹, Chung-Chi Huang^{2

3

4}, Yen-Huey Chen^{2

3

4}

Affiliations

¹ Department of Respiratory Therapy, Chang Gung Memorial Hospital, Keelung, Taiwan.
² Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taiwan.
³ Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
⁴ Department of Respiratory Care, Chang Gung University of Science and Technology, Chia-Yi, Taiwan.

Abstract

Purpose: Muscle atrophy and diaphragm dysfunction are common with prolonged mechanical ventilation (PMV). Electrical stimulation on peripheral muscles has been shown to be beneficial in the improvement of muscle function. This study examined the effects of transcutaneous electrical diaphragmatic stimulation (TEDS) on respiratory muscle strength and weaning outcomes in patients with PMV.

Methods: Participants on ventilation for ≥21 days were randomly assigned to TEDS (n = 29) and control (n = 30) groups. The TEDS group received muscle electrical stimulation for 30 min/session/day throughout the intervention. Pulmonary function parameters (tidal volume, respiratory rate, and rapid shallow breathing index), and respiratory muscle strength (Pimax, Pemax) were assessed. The hospitalization outcome, including weaning rate and length of stay, was followed up until discharge.

Results: After TEDS, there was a significant increase in Pemax (10 [8-20] vs. 20 [10-22] cmH₂O, P = 0.034) in the intervention group. At the end of the study, the improvement of minute volume in the TEDS group (0.64 (-0.67) was significantly higher than the control group (-0.64 (-2.5-0.78) (P = 0.008). In the control group, there was no significant difference between pre- and post-measurement of weaning parameters. There was a significant difference between groups in the weaning rate, with a higher rate in the TEDS group (90%) when compared with that in the control group (66.7%) (P =0.021).

Conclusion: TEDS was significantly associated with increased respiratory muscle strength in patients with PMV. TEDS may be useful to facilitate weaning in this population.

Keywords: Diaphragmatic; electrical stimulation; respiratory muscle; weaning.