Effect of Neuromuscular Electrical Stimulation on the Duration of Mechanical Ventilation

Gutiérrez-Arias, Ruvistay; Zapata-Quiroz, Constanza C; Prenafeta-Pedemonte, Benjamín O; Nasar-Lillo, Nicolás A; Gallardo-Zamorano, Diego I

doi:10.4187/respcare.08363

Cited by 12 publications

(3 citation statements)

References 33 publications

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“…Regardless of the main position of the entire body, the reverse Trendelenburg 57 position has been reported as a recommended strategy to mitigate face pressure sores, ventilator-associated pneumonia, facial edema, eye injuries, lower cranial nerve paralysis, vomiting, transient increase in intracranial pressure, and severe desaturation (Table 4), and is even better if combined with alternating face rotation and repositioning every 2 hours. Despite the well-known safety and benefits of passive mobilization and neuromuscular electrical stimulation in sedated patients [58][59][60][61] , no study has reported early mobilization as a mitigation strategy, which is likely vital to minimize nerve injuries and ICU-acquired weakness after prone positioning.…”

Section: Discussionmentioning

confidence: 99%

Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS

et al. 2021

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INTRODUCTION: Prone positioning is a therapy utilized globally to improve gas exchange, minimize ventilator-induced lung injury, and reduce mortality in acute respiratory distress syndrome (ARDS), particularly during the ongoing coronavirus disease 2019 (COVID-19) pandemic. While the respiratory benefits of prone positioning in ARDS have been accepted, the concurrent complications could be undervalued. Therefore, this study aimed to identify the adverse events related to prone positioning in ARDS, and secondarily, to collect strategies and recommendations to mitigate these adverse events. METHODS: In this scoping review, we searched recommendation documents and original studies published between June 2013 and November 2020 from six relevant electronic databases and the websites of intensive care societies. RESULTS: We selected 41 documents from 121 eligible documents, comprising 13 recommendation documents and 28 original studies (involving 1,578 patients and 994 prone maneuvers). We identified more than 40 individual adverse events, and the highest pooled occurrence rates were that of severe desaturation (37.9%), barotrauma (30.5%), pressure sores (29.7%), ventilationassociated pneumonia (28.2%), facial edema (16.7%), arrhythmia (15.4%), hypotension (10.2%), and peripheral nerve injuries (8.1%). The reported mitigation strategies during prone positioning include alternate face rotation (18 [43.9%]), repositioning every 2 hours (17 [41.5%]), and the use of pillows under the chest and pelvis (14 [34.1%]). The reported mitigation strategies for performing the prone maneuver comprise one person being at the headboard (23 [56.1%]), the use of a pre-maneuver safety checklist (18 [43.9%]), vital sign monitoring (15 [36.6%]), and ensuring appropriate ventilator settings (12 [29.3%]). CONCLUSIONS: We identified >40 adverse events reported in prone positioning ARDS studies, involving additional AEs not yet reported by previous systematic reviews. The Page 3 of 43 Respiratory Care 4 pooled adverse event proportions collected in this review could guide research and clinical practice decisions, and the strategies to mitigate adverse events could promote future consensus-based recommendations.

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Section: Discussionmentioning

confidence: 99%

Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS

et al. 2021

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“…En cuanto a los efectos sistémicos, si bien la RS de Zayed et al, no mostró diferencia en la duración de VM al comparar el uso de EENM y el cuidado estándar (DM = -2,07 días (IC 95% -5,06 a 0,92); 4 ECAs [19] un menor tiempo de VM en los pacientes sometidos a EENM, con una diferencia de medias estandarizada (DME) de -0,65 DE ((IC 95% -1,03 a -0,27); 6 ECAs) [37], hallazgo confirmado por la recientemente publicada RS de Gutiérrez-Arias et al, la cual incluyó 10 ECAs en su MA, y la que reportó que la EENM disminuye en 2,68 días (IC 95% -4,35 a -1,02) la duración de la VM en comparación al cuidado habitual o EENM simulada, lo que podría ser levemente más marcado en pacientes con EPOC como patología de base (DM -2,90 días (IC 95% -4,58 a -1,23); 3 ECAs) [38]. Finalmente, en relación con desenlaces indirectos posiblemente impactados por la aplicación de la EENM, en algunos casos los reportes también son contradictorios.…”

Section: Desenlaces Clínicos Reportados: Revisiones Sistemáticas Y Me...unclassified

Estimulación eléctrica neuromuscular en el paciente crítico. Una revisión narrativa

Gutiérrez-Arias¹,

Contreras²

2022

Rev. chil. anest.

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“…A recent meta systematic review also summarized the value of DES, which can also decrease the duration of invasive mechanical ventilation, while the quality of the body of evidence is low to very low, need more larger number sample randomized controlled trials to confirmed. [13] It is, however, difficult to determine if DES has a therapeutic effect on patients suffering from ICH-related respiratory function in patients on mechanical ventilation.…”

Section: Introductionmentioning

confidence: 99%

Effects of diaphragm electrical stimulation in treating respiratory dysfunction on mechanical ventilation after intracerebral hemorrhage: A single-center retrospective study

Wu,

Wang,

Zhang

et al. 2024

Medicine

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Intracerebral hemorrhage (ICH) is a major cause of death and disability worldwide. The benefits of electrical stimulation in the treatment of respiratory dysfunction in patients on mechanical ventilation is unknown. Nevertheless, there is a dearth of evidence-based medical research concerning its clinical efficacy. From January 2019 to January 2023, every enrolled patients experienced respiratory dysfunction after ICH while being supported by mechanical ventilation. A total of 205 eligible patients were enrolled and then allocated into 2 groups: control group and observation group. 133 patients was selected and administered standard treatment as control group. Based on conventional treatment, other 72 patients were administered diaphragm electrical stimulation (DES) treatment. We examined information from current medical records, encompassing all initial data and predictive follow-up data, such as the weaning success rate, occurrence of ventilator-associated pneumonia (VAP), duration of stay in the intensive care unit (ICU) and hospital, expenses related to hospitalization, and mortality within 30 days. The baseline clinical data of the 2 groups did not exhibit any statistically significant disparities (all P > .05). The rate of successful weaning showed a significant increase in the DES group when compared to the control group (P = .025). In patients with respiratory dysfunction due to ICH, treatment with DES resulted in a significant reduction in the duration of invasive ventilation (9.8 ± 2.1 vs 11.2 ± 2.6, P < .01) and total ventilation time (9.8 ± 2.1 vs 11.2 ± 2.6, P < .01). It also led to a decrease in the length of stay in the ICU (15.67 ± 3.76 vs 17.53 ± 4.28, P = .002) and hospitalization cost (11500 vs 13600, P = .001). Additionally, DES treatment resulted in a lower incidence of VAP (73.61% vs 86.46%, P = .022) and improved 30-day mortality (P < .05), without any significant adverse effects. The findings of this research indicate that DESs have a positive impact on enhancing the rate of successful weaning and reducing the incidence of VAP. It decreases the duration of invasive ventilation and total ventilation time while also improving the mortality rate within 30 days. This therapy could offer a fresh alternative for respiratory impairment in patients undergoing mechanical ventilation.

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Effect of Neuromuscular Electrical Stimulation on the Duration of Mechanical Ventilation

Cited by 12 publications

References 33 publications

Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS

Adverse Events of Prone Positioning in Mechanically Ventilated Adults With ARDS

Estimulación eléctrica neuromuscular en el paciente crítico. Una revisión narrativa

Effects of diaphragm electrical stimulation in treating respiratory dysfunction on mechanical ventilation after intracerebral hemorrhage: A single-center retrospective study

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