Temporary Diaphragm Pacing for Cardiac Surgery Recovery
Author Information
Author(s): Hungate Jessica R. MD, Onders Raymond P. MD, El Diasty Mohammad MD, PhD, Abu-Omar Yasir MD, DPhil, Arora Rakesh C. MD, PhD, Baeza Cristian MD, Elgudin Yakov MD, PhD, Gray Kelsey MD, Markowitz Alan MD, Pelletier Marc MD, Ribeiro Igo B. MD, Vega Pablo Ruda MD, Rushing Gregory D. MD, Sabik Joseph F. III MD
Primary Institution: University Hospitals Cleveland Medical Center
Hypothesis
Immediate diaphragm pacing on admission to the ICU will prevent ventilator-induced diaphragm dysfunction and decrease time on mechanical ventilation.
Conclusion
Temporary diaphragmatic pacing improved weaning from mechanical ventilation by 8 hours with a significant reduction of prolonged mechanical ventilation.
Supporting Evidence
- Only 1 patient in the treatment group was on mechanical ventilation at 24 hours versus 4 patients in the standard of care group.
- The median time on mechanical ventilation was 17.7 hours for the standard of care group and 9.4 hours for the treatment group.
- Temporary diaphragm pacing reduced the relative risk of being on the ventilator by 71% at 24 hours.
- Diaphragm pacing has been shown to treat ventilator-induced diaphragm dysfunction and accelerate weaning in other patient groups.
Takeaway
Using a special device to stimulate the diaphragm helps patients breathe better after heart surgery, making it easier for them to stop using the ventilator.
Methodology
This is a prospective, randomized trial of temporary diaphragmatic pacing electrode use in patients undergoing cardiac surgery.
Potential Biases
Potential bias due to the single-site nature and historical experience with diaphragm pacing.
Limitations
The study is limited by being a single-site study and the exclusion of emergency high-risk surgeries.
Participant Demographics
Patients were primarily older adults with various risk factors for prolonged mechanical ventilation.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI, 8.3-23.4
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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