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Medicina crítica (Colegio Mexicano de Medicina Crítica)

Print version ISSN 2448-8909

Abstract

CARDENAS FAVELA, Juan Carlos et al. Electrostimulation therapy for the treatment of diaphragmatic atrophy induced by mechanical ventilation. Med. crít. (Col. Mex. Med. Crít.) [online]. 2022, vol.36, n.1, pp.50-54.  Epub Oct 28, 2022. ISSN 2448-8909.  https://doi.org/10.35366/104476.

Introduction:

Muscle involvement in critically ill patients is present in the majority of those admitted to the intensive care unit, including alteration of the diaphragmatic muscle, especially during mechanical ventilation (MV). Transcutaneous diaphragmatic electrostimulation therapy (TEDT) has been shown to improve respiratory strength in patients with muscle weakness. However, it has not been evaluated as a treatment for atrophy in Ventilation-Induced Diaphragmatic Dysfunction (DDIVM).

Objective:

To determine if TEDT can improve diaphragmatic thickness in patients undergoing mechanical ventilation.

Material and methods:

A randomized clinical trial was carried out in two independent groups: an intervention group with 15 patients and a control group with 17 patients. The intervention group received TEDT with sessions of 20 minutes every 6 hours in the 72 hours after their inclusion in the study. Baseline diaphragm thickness was measured by ultrasound in both groups, after TEDT for the intervention group and 72 hours later in the control group.

Results:

Of the 32 patients evaluated, a mean initial diaphragmatic thickness was documented for the control group of 2.04 ± 0.43 mm and of 1.9 ± 0.52 mm for the intervention group with a p value of 0.652. After the intervention, a mean final diaphragmatic thickness of 1.7 ± 0.43 mm was recorded for the control group and 2.3 ± 0.55 mm for the intervention group with a p value of 0.002 when comparing both groups.

Conclusion:

A statistically significant difference was found in both groups when applying TEDT, showing an increase in baseline diaphragmatic thickness in the intervention group and a decrease in it in the control group.

Keywords : Mechanical ventilation; diaphragmatic atrophy; diaphragmatic electrostimulation therapy; diaphragmatic thickness.

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