PDF(Pubmed)
Abstract：
UNASSIGNED: Diaphragmatic pacing can improve diaphragm function, which is beneficial for the prognosis of patients treated with prolonged mechanical ventilation (MV). While most previous studies have focused on the role of implanted diaphragm pacing (IDP), our study is the first to examine the effects of external diaphragmatic pacing (EDP) in mechanically ventilated patients. Specifically, the effect of EDP on diaphragm function, the success rate of weaning, the duration of MV (DMV), and the intensive care unit (ICU) length of stay (ILOS) were assessed.
UNASSIGNED: From September 2019 to December 2020, a total of 51 mechanically ventilated patients in the ICU of the Sun Yat-sen Memorial Hospital, Sun Yat-sen University were enrolled and randomly divided into an EDP group of 27 patients and a control group of 24 patients. The control group received routine treatment, and the EDP group received EDP treatment in addition to routine treatment. The diaphragm excursion (DE), diaphragm thickening fraction (DTF), DMV, ILOS, and average survival time were recorded to evaluate efficacy.
UNASSIGNED: Patients treated with EDP had increased DE [exp(B) =1.86, 95% CI: 1.39 to 2.50, P<0.001] and DTF [exp(B) =1.35, 95% CI: 1.05 to 1.76, P=0.022], shortened weaning time (P=0.026) and prolonged average survival time (P<0.001) compared to patients who did not receive EDP therapy. Especially in cases with difficult weaning, the improvement of DE and DTF in the EDP treatment group was more obvious than that in the control group (P=0.013 and P=0.032). Moreover, the DTF upon attempted spontaneous breathing trial (SBT) was negatively correlated with the fraction of inspired oxygen (FiO2) [r=-0.54; 95% confidence interval (CI): -0.77 to -0.19; P=0.004], the arterial partial pressure of oxygen (PaO2) (r=-0.58; 95% CI: -0.79 to -0.25; P=0.001), the PaO2/FiO2 ratio (r=-0.52; 95% CI: -0.75 to -0.16; P=0.006), and the serum lactate concentration (Lac) (r=-0.39; 95% CI: -0.68 to 0.003; P=0.046).
UNASSIGNED: EDP treatment can effectively reduce the DMV and prolong the average survival time of mechanically ventilated patients.
UNASSIGNED: Chinese Clinical Trial Registry ChiCTR1900024096.
UNASSIGNED: From September 2019 to December 2020, a total of 51 mechanically ventilated patients in the ICU of the Sun Yat-sen Memorial Hospital, Sun Yat-sen University were enrolled and randomly divided into an EDP group of 27 patients and a control group of 24 patients. The control group received routine treatment, and the EDP group received EDP treatment in addition to routine treatment. The diaphragm excursion (DE), diaphragm thickening fraction (DTF), DMV, ILOS, and average survival time were recorded to evaluate efficacy.
UNASSIGNED: Patients treated with EDP had increased DE [exp(B) =1.86, 95% CI: 1.39 to 2.50, P<0.001] and DTF [exp(B) =1.35, 95% CI: 1.05 to 1.76, P=0.022], shortened weaning time (P=0.026) and prolonged average survival time (P<0.001) compared to patients who did not receive EDP therapy. Especially in cases with difficult weaning, the improvement of DE and DTF in the EDP treatment group was more obvious than that in the control group (P=0.013 and P=0.032). Moreover, the DTF upon attempted spontaneous breathing trial (SBT) was negatively correlated with the fraction of inspired oxygen (FiO2) [r=-0.54; 95% confidence interval (CI): -0.77 to -0.19; P=0.004], the arterial partial pressure of oxygen (PaO2) (r=-0.58; 95% CI: -0.79 to -0.25; P=0.001), the PaO2/FiO2 ratio (r=-0.52; 95% CI: -0.75 to -0.16; P=0.006), and the serum lactate concentration (Lac) (r=-0.39; 95% CI: -0.68 to 0.003; P=0.046).
UNASSIGNED: EDP treatment can effectively reduce the DMV and prolong the average survival time of mechanically ventilated patients.
UNASSIGNED: Chinese Clinical Trial Registry ChiCTR1900024096.
摘要：
UNASSIGNED：膈肌起搏可改善膈肌功能，这有利于长期机械通气（MV）治疗患者的预后。虽然以前的大多数研究都集中在植入式膈肌起搏（IDP）的作用上，我们的研究首次研究了体外膈肌起搏(EDP)对机械通气患者的影响.具体来说,EDP对隔膜功能的影响，断奶成功率,MV的持续时间(DMV)，并评估重症监护病房(ICU)住院时间(ILOS).
UNASSIGNED：自2019年9月至2020年12月，共有51名机械通气患者在孙逸仙纪念医院ICU，选择中山大学为研究对象,随机分为EDP组27例和对照组24例。对照组给予常规治疗,EDP组除常规治疗外还接受EDP治疗。隔膜偏移(DE),隔膜增厚分数（DTF），车管所,ILOS,并记录平均生存时间以评价疗效。
未经证实：接受EDP治疗的患者DE[exp（B）=1.86，95％CI：1.39至2.50，P<0.001]和DTF[exp（B）=1.35，95％CI：1.05至1.76，P=0.022]，与未接受EDP治疗的患者相比,患者的断奶时间缩短(P=0.026),平均生存时间延长(P<0.001).尤其是在断奶困难的情况下，EDP治疗组DE和DTF改善较对照组更明显(P=0.013和P=0.032)。此外，尝试自主呼吸试验（SBT）时的DTF与吸入氧气分数（FiO2）呈负相关[r=-0.54；95％置信区间（CI）：-0.77至-0.19；P=0.004]，动脉血氧分压（PaO2）（r=-0.58；95％CI：-0.79至-0.25；P=0.001），PaO2/FiO2比值（r=-0.52；95%CI：-0.75至-0.16；P=0.006），和血清乳酸浓度（Lac）（r=-0.39；95％CI：-0.68至0.003；P=0.046）。
UNASSIGNED：EDP治疗可有效降低DMV，延长机械通气患者的平均生存时间。
未经批准：中国临床试验注册中心ChiCTR1900024096。
UNASSIGNED：自2019年9月至2020年12月，共有51名机械通气患者在孙逸仙纪念医院ICU，选择中山大学为研究对象,随机分为EDP组27例和对照组24例。对照组给予常规治疗,EDP组除常规治疗外还接受EDP治疗。隔膜偏移(DE),隔膜增厚分数（DTF），车管所,ILOS,并记录平均生存时间以评价疗效。
未经证实：接受EDP治疗的患者DE[exp（B）=1.86，95％CI：1.39至2.50，P<0.001]和DTF[exp（B）=1.35，95％CI：1.05至1.76，P=0.022]，与未接受EDP治疗的患者相比,患者的断奶时间缩短(P=0.026),平均生存时间延长(P<0.001).尤其是在断奶困难的情况下，EDP治疗组DE和DTF改善较对照组更明显(P=0.013和P=0.032)。此外，尝试自主呼吸试验（SBT）时的DTF与吸入氧气分数（FiO2）呈负相关[r=-0.54；95％置信区间（CI）：-0.77至-0.19；P=0.004]，动脉血氧分压（PaO2）（r=-0.58；95％CI：-0.79至-0.25；P=0.001），PaO2/FiO2比值（r=-0.52；95%CI：-0.75至-0.16；P=0.006），和血清乳酸浓度（Lac）（r=-0.39；95％CI：-0.68至0.003；P=0.046）。
UNASSIGNED：EDP治疗可有效降低DMV，延长机械通气患者的平均生存时间。
未经批准：中国临床试验注册中心ChiCTR1900024096。
