Transcutaneous electrostimulation programming for mechanical ventilation induced diaphragmatic weakness

Authors

DOI:

https://doi.org/10.56294/saludcyt20241014

Keywords:

Transcutaneous Electrostimulation, Diaphragmatic Weakness, Mechanical Ventilation, Intensive Care Unit

Abstract

Introduction: diaphragmatic weakness caused by mechanical ventilation includes many different alterations derived from the muscle inactivity during this process. Structurally, the diaphragm undergoes atrophy due to its lack of use. One of the relevant treatments used to aid this muscle’s strengthening is the transcutaneous electrical nerve stimulation (TENS) which consists of the superficial application of an electrical current.                                                   
Objective: to stablish the programming for transcutaneous electrostimulation on mechanical ventilation induced diaphragmatic weaknees.                                                                                   
Materials and methods: an exhaustive systematic review of the scientific literature. The data compilation was performed though scientific database, including: Pubmed, Scielo, and Google Scholar. The information was evaluated using the PRISMA method, within the last 5 years.                                                   
Results: the results pointed that a two-phase symmetrical stimulation was the predominant pattern. With a stimulation frequency between 30 Hz to 50 Hz, which proved to be effective and beneficial. The electrical pulse duration varied between 200 to 400 microseconds, showing a favorable effect with therapeutic properties.                   Conclusions: the use of TENS improves the functional capacity of the diaphragm significantly

References

1. Vassilakopoulos T. Ventilator-induced diaphragm dysfunction: the clinical relevance of animal models. Intensive Care Med [Internet]. 1 de enero de 2008 [citado 19 de abril de 2024];34(1):7-16. Disponible en: https://doi.org/10.1007/s00134-007-0866-x

2. Vassilakopoulos T, Zakynthinos S, Roussos C. Bench-to-bedside review: Weaning failure – should we rest the respiratory muscles with controlled mechanical ventilation? Crit Care [Internet]. 2006 [citado 19 de abril de 2024];10(1):204. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550863/

3. Vassilakopoulos T, Petrof BJ. Ventilator-induced Diaphragmatic Dysfunction. Am J Respir Crit Care Med [Internet]. febrero de 2004 [citado 19 de abril de 2024];169(3):336-41. Disponible en: https://www.atsjournals.org/doi/10.1164/rccm.200304-489CP

4. Petrof BJ, Jaber S, Matecki S. Ventilator-induced diaphragmatic dysfunction: Current Opinion in Critical Care [Internet]. febrero de 2010 [citado 19 de abril de 2024];16(1):19-25. Disponible en: http://journals.lww.com/00075198-201002000-00005

5. Itagaki T. Diaphragm-protective mechanical ventilation in acute respiratory failure. 2022;69.

6. Salazar Coba SD, Guerrero Toapanta F, Del Pozo G. Caracterización demográfica y epidemiológica de la Unidad de Cuidados Intensivos del Hospital de Especialidades Carlos Andrade Marín de los años 2014, 2015 y 2016.

7. Cárdenas Favela JC, Godínez García F, Beltrán de la Luz MG, Juárez González CE, Hernández González MA. Terapia de electroestimulación para el tratamiento de la atrofia diafragmática inducida por ventilación mecánica [Internet]. [citado 19 de abril de 2024]. Disponible en: https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2448-89092022000100050

8. Ruiz C, Díaz MÁ, Zapata JM, Bravo S, Panay S, Escobar C, et al. Características y evolución de los pacientes que ingresan a una Unidad de Cuidados Intensivos de un hospital público. Revista médica de Chile [Internet]. octubre de 2016 [citado 19 de abril de 2024];144(10):1297-304. Disponible en: http://www.scielo.cl/scielo.php?script=sci_abstract&pid=S0034-98872016001000009&lng=es&nrm=iso&tlng=es

9. Hsin YF, Chen SH, Yu TJ, Huang CC, Chen YH. Effects of transcutaneous electrical diaphragmatic stimulation on respiratory function in patients with prolonged mechanical ventilation. Ann Thorac Med [Internet]. 2022 [citado 19 de abril de 2024];17(1):14-20. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8809123/

10. Marcos F, Noelia PFS, Claudia D, Matías G, Eduardo D, Magdalena B, et al. Electroestimulación en el paciente crítico. 2018;18.

11. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Rev Esp Cardiol [Internet]. 1 de septiembre de 2021 [citado 19 de abril de 2024];74(9):790-9. Disponible en: http://www.revespcardiol.org/es-declaracion-prisma-2020-una-guia-articulo-S0300893221002748

12. Cascaes da Silva F, Valdivia Arancibia BA, da Rosa Iop R, Barbosa Gutierres Filho PJ, da Silva R. Escalas y listas de evaluación de la calidad de estudios científicos. Revista Cubana de Información en Ciencias de la Salud [Internet]. septiembre de 2013 [citado 19 de abril de 2024];24(3):295-312. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S2307-21132013000300007&lng=es&nrm=iso&tlng=es

13. Foley NC, Teasell RW, Bhogal SK, Speechley MR. Stroke Rehabilitation Evidence-Based Review: methodology. Top Stroke Rehabil. 2003;10(1):1-7.

14. Medrinal C, Machefert M, Lamia B, Bonnevie T, Gravier FE, Hilfiker R, et al. Transcutaneous electrical diaphragmatic stimulation in mechanically ventilated patients: a randomised study. Crit Care [Internet]. 30 de agosto de 2023 [citado 19 de abril de 2024];27:338. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469422/

15. Liu Y, Gong Y, Zhang C, Meng P, Gai Y, Han X, et al. Effect of neuromuscular electrical stimulation combined with early rehabilitation therapy on mechanically ventilated patients: a prospective randomized controlled study. BMC Pulm Med [Internet]. 21 de julio de 2023 [citado 19 de abril de 2024];23:272. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362773/

16. Abu-Khaber HA, Abouelela AMZ, Abdelkarim EM. Effect of electrical muscle stimulation on prevention of ICU acquired muscle weakness and facilitating weaning from mechanical ventilation. Alexandria Journal of Medicine [Internet]. 1 de diciembre de 2013 [citado 19 de abril de 2024];49(4):309-15. Disponible en: https://doi.org/10.1016/j.ajme.2013.03.011

17. Nagy L. Nassef, Ph.D. SMH M Sc;, Awny F. Rahmy, Ph.D. MMEB. Outcome Measures of Acute Transcutaneous Electrical Diaphragmatic Stimulation in Mechanically Ventilated Patients. The Medical Journal of Cairo University [Internet]. 1 de septiembre de 2022 [citado 19 de abril de 2024];90(9):1743-8. Disponible en: https://mjcu.journals.ekb.eg/article_272625.html

18. Wu Y, Wang S, Zhang J, Wang Y, Zhong J, Wang Y. Effects of diaphragm electrical stimulation in treating respiratory dysfunction on mechanical ventilation after intracerebral hemorrhage: A single-center retrospective study. Medicine [Internet]. 5 de enero de 2024 [citado 19 de abril de 2024];103(1):e36767. Disponible en: https://journals.lww.com/md-journal/fulltext/2024/01050/effects_of_diaphragm_electrical_stimulation_in.55.aspx

19. Duarte GL, Bethiol AL, Ratti L dos SR, Franco G, Moreno R, Tonella RM, et al. Transcutaneous electrical diaphragmatic stimulation reduces the duration of invasive mechanical ventilation in patients with cervical spinal cord injury: retrospective case series. Spinal Cord Ser Cases [Internet]. 9 de abril de 2021 [citado 19 de abril de 2024];7(1):1-6. Disponible en: https://www.nature.com/articles/s41394-021-00396-4

20. dos Santos FV, Cipriano Jr G, Vieira L, Güntzel Chiappa AM, Cipriano GBF, Vieira P, et al. Neuromuscular electrical stimulation combined with exercise decreases duration of mechanical ventilation in ICU patients: A randomized controlled trial. Physiotherapy Theory and Practice [Internet]. 3 de mayo de 2020 [citado 19 de abril de 2024];36(5):580-8. Disponible en: https://doi.org/10.1080/09593985.2018.1490363

21. Soták M, Roubík K, Henlín T, Tyll T. Phrenic nerve stimulation prevents diaphragm atrophy in patients with respiratory failure on mechanical ventilation. BMC Pulmonary Medicine [Internet]. 8 de octubre de 2021 [citado 19 de abril de 2024];21(1):314. Disponible en: https://doi.org/10.1186/s12890-021-01677-2

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Published

2024-01-01

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Section

Systematic reviews or meta-analyses

How to Cite

1.
Sangoquiza Chicaiza EP, Caiza Lema SJ. Transcutaneous electrostimulation programming for mechanical ventilation induced diaphragmatic weakness. Salud, Ciencia y Tecnología [Internet]. 2024 Jan. 1 [cited 2024 Dec. 4];4:1014. Available from: https://sct.ageditor.ar/index.php/sct/article/view/743