Electrical Phrenic Nerve Stimulation in Patients With VIDD
Electrical Phrenic Nerve Stimulation in Patients With Ventilator-induced Diaphragm Dysfunction: a Randomized Controlled Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Zongyu Wang, Dr.
- Phone Number: 008601082267028
- Email: wangzy1976@126.com
Study Locations
-
-
Beijing
-
Beijing, Beijing, China, 100191
- Recruiting
- Peking University Third Hospital
-
Contact:
- Zongyu Wang, Doctor
- Phone Number: 86-010-82267028
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- aged ≥ 18 years
- ventilated for at least 48 h with an expected stay of more than 7 days in the ICU
- diaphragm thickening fraction (DTF)< 25%
Exclusion Criteria:
- having a pacemaker
- cutaneous lesion that could interfere with probes
- previous diaphragmatic nerve paralysis
- body mass index > 35 kg/m2
- severe chronic obstructive pulmonary disease (FEV1/FVC<30%)
- pregnancy or lactation
- decision to withhold life-sustaining treatment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: transcutaneous electrical phrenic nerve stimulation (TEPNS) group
The patients in TEPNS group receive TEPNS and usual care.
|
TEPNS is conducted twice a day for consecutive 5 days.
Electrodes are applied to bilateral neck skin which phrenic nerve runs underneath.
|
|
No Intervention: Control group
The patients in control group receive usual care only.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Transdiaphragmatic pressure (Pdi)
Time Frame: Collected once a day after transcutaneous electrical phrenic nerve stimulation (TEPNS) for consecutive 5 days
|
Pdi=gastric pressure - esophageal pressure
|
Collected once a day after transcutaneous electrical phrenic nerve stimulation (TEPNS) for consecutive 5 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Airway pressure, esophageal pressure, gastric pressure, airway occlusion pressure, driving pressure, transpulmonary pressure
Time Frame: Collected once a day after TEPNS for consecutive 5 days
|
Determined from respiratory mechanics indicators provided by ventilator or calculated from them
|
Collected once a day after TEPNS for consecutive 5 days
|
|
Esophageal pressure-time product
Time Frame: Collected once a day after TEPNS for consecutive 5 days
|
Determined from respiratory mechanics indicators provided by ventilator
|
Collected once a day after TEPNS for consecutive 5 days
|
|
Ventilation days
Time Frame: Collected at 28 days after enrollment
|
Mechanical ventilation days in 28 days after enrollment
|
Collected at 28 days after enrollment
|
|
Length of ICU stay
Time Frame: Collected at 28 days after enrollment
|
Days of ICU stay in 28 days after enrollment
|
Collected at 28 days after enrollment
|
|
28-day mortality
Time Frame: Collected at 28 days after enrollment
|
Survival outcomes
|
Collected at 28 days after enrollment
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Zongyu Wang, Dr., Peking University Third Hospital
Publications and helpful links
General Publications
- Goligher EC, Dres M, Patel BK, Sahetya SK, Beitler JR, Telias I, Yoshida T, Vaporidi K, Grieco DL, Schepens T, Grasselli G, Spadaro S, Dianti J, Amato M, Bellani G, Demoule A, Fan E, Ferguson ND, Georgopoulos D, Guerin C, Khemani RG, Laghi F, Mercat A, Mojoli F, Ottenheijm CAC, Jaber S, Heunks L, Mancebo J, Mauri T, Pesenti A, Brochard L. Lung- and Diaphragm-Protective Ventilation. Am J Respir Crit Care Med. 2020 Oct 1;202(7):950-961. doi: 10.1164/rccm.202003-0655CP.
- Bao Q, Chen L, Chen X, Li T, Xie C, Zou Z, Huang C, Zhi Y, He Z. The effects of external diaphragmatic pacing on diaphragm function and weaning outcomes of critically ill patients with mechanical ventilation: a prospective randomized study. Ann Transl Med. 2022 Oct;10(20):1100. doi: 10.21037/atm-22-4145.
- Medrinal C, Machefert M, Lamia B, Bonnevie T, Gravier FE, Hilfiker R, Prieur G, Combret Y. Transcutaneous electrical diaphragmatic stimulation in mechanically ventilated patients: a randomised study. Crit Care. 2023 Aug 30;27(1):338. doi: 10.1186/s13054-023-04597-1.
- O'Rourke J, Sotak M, Curley GF, Doolan A, Henlin T, Mullins G, Tyll T, Omlie W, Ranieri MV. Initial Assessment of the Percutaneous Electrical Phrenic Nerve Stimulation System in Patients on Mechanical Ventilation. Crit Care Med. 2020 May;48(5):e362-e370. doi: 10.1097/CCM.0000000000004256.
- Sotak M, Roubik K, Henlin T, Tyll T. Phrenic nerve stimulation prevents diaphragm atrophy in patients with respiratory failure on mechanical ventilation. BMC Pulm Med. 2021 Oct 8;21(1):314. doi: 10.1186/s12890-021-01677-2.
- Poulard T, Bachasson D, Fosse Q, Nierat MC, Hogrel JY, Demoule A, Gennisson JL, Dres M. Poor Correlation between Diaphragm Thickening Fraction and Transdiaphragmatic Pressure in Mechanically Ventilated Patients and Healthy Subjects. Anesthesiology. 2022 Jan 1;136(1):162-175. doi: 10.1097/ALN.0000000000004042.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
Other Study ID Numbers
- TEPNS_01
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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