title: Abdominal Functional Electrical Stimulation to Assist Ventilator Weaning in Acute Tetraplegia: A Cohort Study.
abstract: BACKGROUND
  Severe impairment of the major respiratory muscles resulting from tetraplegia reduces respiratory function, causing many people with tetraplegia to require mechanical ventilation during the acute stage of injury. Abdominal Functional Electrical Stimulation (AFES) can improve respiratory function in non-ventilated patients with sub-acute and chronic tetraplegia. The aim of this study was to investigate the clinical feasibility of using an AFES training program to improve respiratory function and assist ventilator weaning in acute tetraplegia.
  
  
  METHODS
  AFES was applied for between 20 and 40 minutes per day, five times per week on four alternate weeks, with 10 acute ventilator dependent tetraplegic participants. Each participant was matched retrospectively with a ventilator dependent tetraplegic control, based on injury level, age and sex. Tidal Volume (VT) and Vital Capacity (VC) were measured weekly, with weaning progress compared to the controls.
  
  
  RESULTS
  Compliance to training sessions was 96.7%. Stimulated VT was significantly greater than unstimulated VT. VT and VC increased throughout the study, with mean VC increasing significantly (VT: 6.2 mL/kg to 7.8 mL/kg VC: 12.6 mL/kg to 18.7 mL/kg). Intervention participants weaned from mechanical ventilation on average 11 (sd: ± 23) days faster than their matched controls.
  
  
  CONCLUSIONS
  The results of this study indicate that AFES is a clinically feasible technique for acute ventilator dependent tetraplegic patients and that this intervention may improve respiratory function and enable faster weaning from mechanical ventilation.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02200393.
authors.affiliation: Centre for Rehabilitation Engineering, School of Engineering, University of Glasgow, University Avenue, Glasgow, United Kingdom; Centre for Excellence in Rehabilitation Research, Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom; Centre for Health Systems and Safety Research, Australia Institute of Health Innovation, Macquarie University, North Ryde, Australia; Scottish Centre for Innovation in Spinal Cord Injury, Glasgow, United Kingdom.
authors.forename: Euan J
authors.initials: EJ
authors.lastname: McCaughey
authors.affiliation: Centre for Excellence in Rehabilitation Research, Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom; Scottish Centre for Innovation in Spinal Cord Injury, Glasgow, United Kingdom.
authors.forename: Helen R
authors.initials: HR
authors.lastname: Berry
authors.affiliation: Queen Elizabeth National Spinal Injuries Unit, Southern General Hospital, Glasgow, United Kingdom; Scottish Centre for Innovation in Spinal Cord Injury, Glasgow, United Kingdom.
authors.forename: Alan N
authors.initials: AN
authors.lastname: McLean
authors.affiliation: Queen Elizabeth National Spinal Injuries Unit, Southern General Hospital, Glasgow, United Kingdom; Scottish Centre for Innovation in Spinal Cord Injury, Glasgow, United Kingdom.
authors.forename: David B
authors.initials: DB
authors.lastname: Allan
authors.affiliation: Centre for Rehabilitation Engineering, School of Engineering, University of Glasgow, University Avenue, Glasgow, United Kingdom; Scottish Centre for Innovation in Spinal Cord Injury, Glasgow, United Kingdom.
authors.forename: Henrik
authors.initials: H
authors.lastname: Gollee
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004558:Electric Stimulation / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000628:therapy*; D013990:Tidal Volume; D015300:Ventilator Weaning / Q000295:instrumentation / Q000379:methods*; D014797:Vital Capacity; D055815:Young Adult