The impact of extracorporeal diaphragm pacing therapy on diaphragm function in critically III patients dependent on mechanical ventilation: a double-blind randomized controlled trial

体外膈肌起搏疗法对依赖机械通气的危重III期患者膈肌功能的影响:一项双盲随机对照试验

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Abstract

BACKGROUND: To evaluate the impact of extracorporeal diaphragm pacing (EDP) therapy on diaphragm function in critically ill patients reliant on mechanical ventilation. METHODS: Patients were randomly divided into an observation group (39 cases) and a control group (40 cases) using a random number table. Both groups received bedside rehabilitation interventions. Additionally, the observation group underwent EDP therapy 6 times weekly for 2 weeks. Diaphragm activity, diaphragm thickness, arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2), and Oxygenation Index (OI) were measured at baseline and 2 weeks postenrollment or upon extubation. RESULTS: Both groups showed significant improvements in diaphragm activity, PaO2, PaCO2, and OI compared to baseline (P <.05). The observation group had significantly better outcomes in diaphragm thickness (0.22 ± 0.03), diaphragm activity (13.96 ± 0.73), PaCO2 (37.59 ± 5.66), and OI (271.10 ± 17.25) compared to the control group (0.20 ± 0.02, 12.24 ± 0.99, 47.25 ± 5.64, 248.60 ± 15.26), with statistical significance (P <.05). CONCLUSION: EDP therapy offers benefits in improving diaphragm function in critically ill patients on mechanical ventilation. It enhances diaphragm strength and endurance, increases diaphragm activity, improves pulmonary ventilation, and reduces mechanical ventilation duration.

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