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Effects of Neuromuscular Electrical Stimulation on Critically Ill Patients With Mechanical Ventilation

2022年2月14日 更新者：JinyanXing、The Affiliated Hospital of Qingdao University
Up to 25% of patients who require mechanical ventilation (MV) more than seven days in the intensive care unit (ICU) develop muscle weakness, which comprises deep muscle weakness , including the respiratory muscles.Early active mobilization in ICU patients is a safe and viable strategy to prevent the physical problems caused by immobility. Neuromuscular electrical stimulation (NMES) is an alternative to mobilize and exercise because it does not require active patient participation and can be used on bedridden patients.No previous studies have shown whether training-specific respiratory muscles using an electrical stimulation can have overall benefits for ICU patients on MV.For this reason, the aim of this study was to evaluate, the effectiveness of the NMES therapy combined with early rehabilitation in the respiratory muscles of patients on MV.

研究概览

地位

招聘中

条件

干预/治疗

研究类型

介入性

注册 (预期的)

47

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

学习地点

  • 中国
      • Qingdao、中国、266003
        • 招聘中
        • Neuromuscular electrical stimulation
        • 接触：

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 至 80年 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Prolonged MV(>72 h);
  • Written informed consent was obtained from the patients or their relatives

Exclusion Criteria:

  • Previous neuromuscular disease;
  • Unrelieved pneumothorax, restricted diaphragmatic dyskinesia including abdominal high pressure, a large number of ascites
  • Thoracic or diaphragmatic malformation;
  • Local skin damage and infection;
  • Indwelling a temporary or permanent pacemaker;
  • Severe obesity(BMI>35 kg/m2)
  • Various reasons (severe intestinal gas accumulation, structural abnormalities) lead to the failure of ultrasonic detection of diaphragm movement;
  • Patients with an expected survival time of less than 7 days or with palliative care

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：单身的

武器和干预

参与者组/臂
干预/治疗
实验性的：NMSE Group
Neuromuscular Electrical Stimulation(NMES) group received consecutive daily sessions of electrical stimulation at specific points starting on the first day of randomization.The subjects also receive conventional physical therapy, which included gross motor therapy and respiratory therapy twice a day every day during their stay in the ICU.
行为的：Neuromuscular Electrical Stimulation
NMES was performed using a portable machine.The negative electrodes were placed in the motor points of the following muscles: chest muscles (pectoralis major muscle fibres) and rectus abdominis muscles bilaterally. A second (positive) electrode was positioned distally to the first, at a site close to the muscle that was being electrically stimulated, totalling 1 channel with 2 electrodes for each muscle . Each NMES session lasted 30 min. The following parameters were used: 50 Hz frequency, pulse duration 300 ms, rise time 1 s, stimulus time (ON) 3 s, decay time 1 s, and relaxation time (OFF) 10 s. Intensity was increased until muscle contraction was visible or could be identified through palpation. In conscious patients, intensity was adjusted according to their tolerance.
无干预：CPT group
The subjects only receive conventional physical therapy, which included gross motor therapy and respiratory therapy twice a day every day during their stay in the ICU.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
diaphragmatic thickening fraction(DTF)
大体时间：baseline,Day 3 of mechanical ventilation,Day 7 of mechanical ventilation,before extubation
DTF shows varied thickness of the diaphragm at end-expiration and end-inspiration. Te maximum and minimum values of each breathing cycle were taken as the end-inspiratory diaphragm thickness (DTei) and the end-expiratory diaphragm thickness (DTee), respectively. DTF was calculated by DTF=(DTei DTee)/DTee 100%. Te values for 3 consecutive respiratory cycles were recorded and the average value was taken as the fnal value
baseline,Day 3 of mechanical ventilation,Day 7 of mechanical ventilation,before extubation

次要结果测量

结果测量
措施说明
大体时间
Parasternal Intercostal Muscle Ultrasound
大体时间：baseline,Day 3 of mechanical ventilation,Day 7 of mechanical ventilation,before extubation
A 10- to 15-MHz linear array transducer was positioned perpendicular to the anterior thorax surface in the longitudinal scan, at the level of the second right intercostal space, approximately 6 to 8 cm lateral to the sternal edge with a window visualizing the second and third ribs. . Using M-mode, the ultrasound beam was perpendicularly directed at the midsection of the muscle, where it is the thinnest at end-expiration. The thickness of the parasternal intercostal muscle was measured on frozen images at end expiration and at peak inspiration.
baseline,Day 3 of mechanical ventilation,Day 7 of mechanical ventilation,before extubation

其他结果措施

结果测量
大体时间
ventilator-free days at 28 days
大体时间：28 days
28 days

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

The Affiliated Hospital of Qingdao University

调查人员

  • 研究主任：Jinyan Xing, Dr.、The Affiliated Hospital of Qingdao University

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2022年2月1日

初级完成 (预期的)

2022年8月31日

研究完成 (预期的)

2022年8月31日

研究注册日期

首次提交

2022年1月8日

首先提交符合 QC 标准的

2022年1月27日

首次发布 (实际的)

2022年2月1日

研究记录更新

最后更新发布 (实际的)

2022年3月2日

上次提交的符合 QC 标准的更新

2022年2月14日

最后验证

2022年2月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • DZH20220104

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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