Immediate Hemodynamic Responses to Transcutaneous Electrical Diaphragmatic Stimulation in Critically Ill Elderly Patients

Abstract

Background. Critically ill patients admitted to intensive care units (ICUs) may develop diaphragmatic dysfunction, especially when artificial airways are used. Positive effects have been observed when using the transcutaneous electrical diaphragmatic stimulation (TEDS) technique in different clinical conditions. However, no study has evaluated the safety of TEDS in patients admitted to ICUs. This study is aimed at evaluating the influence of TEDS on the hemodynamic and vital parameters of critically ill elderly patients under invasive mechanical ventilation (IMV). Methods. Forty-seven patients aged >60 years under IMV were evaluated for hemodynamic variables before and after TEDS. The procedure lasted 30 minutes and was performed once. Results. The sample consisted of 33 men and 14 women with a mean age of $69.9\pm 7.64$ years. The mean systolic blood pressures pre-TEDS and post-TEDS were $126.6\pm 23.7$ and $122.9\pm 25.9$ , respectively ( $p=0.467$ ). The mean diastolic blood pressures pre-TEDS and post-TEDS were $71.1\pm 12.2$ and $67.7\pm 14.2$ , respectively ( $p=0.223$ ). No significant differences in the mean arterial pressure or heart rate were found between the pre-TEDS and post-TEDS time points ( $p=0.335$ and $p=0.846$ , respectively). Conclusion. Our findings suggest that TEDS does not have clinically relevant impacts on hemodynamic or vital parameters in critically ill elderly patients. These findings point to the possible safety of TEDS application in this population.