Effect of Transcutaneous Electrical Co-Activation of Diaphragm and Abdominal Muscles on Weaning Time in Mechanically Ventilated Patients

Shaimaa Elsayed Ahmad, H. Obaya, Ahmad Tarek, Abd Algawad, Gehad Ali Abdelhaseeb, Donia M. Elmasry
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Abstract

Background : In intensive care units (ICUs), around one-third of severely sick patients need mechanical ventilation (MV) to maintain their breathing; some require it for just hours, while others need it for months. The diaphragm, abdominal, and intercostal muscles—the three main breathing muscles—may experience atrophy due to lack of usage during this period. Objective: We aimed to determine the effect of transcutaneous electrical co-activation of diaphragm and abdominal muscles on weaning time in MV patients. Patients and Methods : A total of 52 mechanically ventilated patients of both sexes participated in the study with age range from 40 to 55 years old. They were recruited from ICU Department in New Cairo Generalized Hospital; referred by physicians. They were assigned randomly into 2 Groups. Group A consisted of 26 patients; received co-activation of both diaphragmatic electrical stimulation and abdominal functional stimulation in addition to conventional physical program for one session per day for 7 days a week till discharge, 60 minutes per session. Group B consisted of 26 patients; received conventional physical therapy program for 30 minutes per session for one session a day for 7 sessions a week till discharge. Outcome measure weaning time was assessed. Results : Both groups showed significant improvements in the weaning time. However, Group A demonstrated greater improvements compared to Group B. Conclusion: Application of transcutaneous diaphragmatic stimulation and abdominal functional electrical stimulation is safe way for critically ill patients for decreasing length of duration in ICU for mechanically ventilated patient thus improve weaning.
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经皮膈肌和腹肌电协同激活对机械通气患者断奶时间的影响
背景:在重症监护室(ICU)中,大约三分之一的重症患者需要机械通气(MV)来维持呼吸。在此期间,膈肌、腹肌和肋间肌(三块主要呼吸肌)可能会因缺乏锻炼而萎缩。研究目的我们的目的是确定经皮电刺激膈肌和腹肌对中风患者断奶时间的影响。患者和方法:共有 52 名男女机械通气患者参与研究,年龄在 40 岁至 55 岁之间。他们由医生推荐,从新开罗综合医院重症监护室招募而来。他们被随机分配到两组。A 组有 26 名患者,除了常规的物理治疗外,还同时接受膈肌电刺激和腹部功能刺激,每天一次,每周 7 天,直到出院,每次 60 分钟。B 组有 26 名患者,接受常规物理治疗,每周 7 天,每天 1 次,每次 30 分钟,直至出院。结果对断奶时间进行了评估。结果:两组患者的断奶时间均有明显改善。结论:应用经皮膈肌治疗后,患者的断奶时间明显缩短:对重症患者来说,经皮膈肌刺激和腹部功能性电刺激是一种安全的方法,可缩短机械通气患者在重症监护室的住院时间,从而缩短断奶时间。
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