Transcutaneous electrical diaphragmatic stimulation reduces the duration of invasive mechanical ventilation in patients with cervical spinal cord injury: retrospective case series

Study design Retrospective case series. Objectives To compare individuals with cervical spinal cord injury (SCI) submitted to transcutaneous electrical diaphragmatic stimulation (TEDS) or a standard weaning protocol (SWP) according to the following variables: invasive mechanical ventilation (IMV) time, ventilator weaning time, intensive care unit (ICU) length of stay, and overall hospital length of stay. Settings Tertiary university hospital. Clinical Hospital of Campinas State University-UNICAMP-Campinas (SP), Brazil. Methods Retrospective case study investigating ICU patients submitted to tracheostomy due to cervical SCI at a tertiary university hospital (Clinical Hospital of Campinas State University, Brazil). Data were extracted from medical records of patients seen between January 2007 and December 2016. According to medical records, four patients were submitted to TEDS and six to a SWP. Provision of training to patients in the TEDS group was based on consensus medical decision, preference of the physical therapy team and availability of electrostimulation equipment in the ICU. Results Total IMV time in the TEDS and the SWP group was 33 +/- 15 and 60 +/- 22 days, respectively. Length of stay in ICU in the TEDS and the SWP group was 31 +/- 18 and 63 +/- 45 days, respectively. Conclusion TEDS appears to influence the duration of IMV as well as the length of stay in ICU. This physiotherapeutic intervention may be a potentially promising tool for treatment of patients with SCI. However, randomized clinical trials are warranted to support this assumption.

Automated summary

This retrospective case series compared individuals with cervical SCI treated with TEDS or SWP, finding that TEDS may influence IMV duration and ICU length of stay. However, further randomized clinical trials are needed to support this conclusion.