Dear participant Participants's patient, who is participants's first-degree relative, who is connected to a ventilator in the intensive care unit, unconscious and not authorized to give informed consent, has been invited to participate in the study titled 'Does transcutaneous phrenic nerve stimulation prevent diaphragm atrophy?
In order to strengthen this muscle and prevent loss of function, investigator provide electrical stimulation between the rib cage and abdomen through the skin with the tens device, causing the muscle to contract and enabling our patient to leave the respirator early.
Investigator aimed to investigate the protective effect of the tens device on the diaphragm by evaluating the diaphragm muscle with the ultrasonography device during the period when it is connected to the respirator. For this reason, the diaphragm will be contracted by giving electrical stimulation three times a day for 30 minutes with the tens device for 5 days during the period when participants's patient is connected to the respirator, and intermittent diaphragm ultrasound will be evaluated.
Participants or participants's legal guardian are asked to approve the use of participants's medical records during participants's treatment in the intensive care unit, provided that participants's personal information is kept confidential. Participants will not incur any financial burden by participating in the study and participants will not receive any additional payment.
Participants are free to leave the study at any time if deemed necessary, and the researcher can terminate the study if deemed necessary. The information obtained within the scope of the research can be used for scientific purposes and can be presented and published provided that the confidentiality record is respected.
I have read (or orally listened to) the text above, which contains the information given to the participants before the research began. I agree to participate in the study as a Volunteer. I consent to the use of my medical information. I also understand that if I do not agree to participate in the study, my treatment will be carried out in full without interruption.
Participant name and surname:
Participant's relative's name and surname:
Degree of closeness:
Signature / Date:
None
Patients with less than 72 hours of mechanical ventilation
Pregnancy
Patients with a body mass index above 35kg/m²
Neuromuscular disease
Patients on invasive mechanical ventilation for 72 hours or more Patients older than 18 years
Cohort
Prospective
Not listed
Primary Outcome: Diaphragm atrophy, ventilator-associated diaphragm dysfunction
By performing phrenic nerve stimulation with TEDS device, the thickness change in the diaphragm muscle will be measured by usg at the end of 5 days. The thickness of the diaphragm muscle will be measured in inspiratory and expiratory. Atrophy will be determined according to the change in thickness. Diaphragm thickening fraction will be calculated by formilizing the thickness in inspiratory and expiratory and diaphragm dysfunction will be determined.DTF (End-inspiratory thickness - End-expiratory thickness)/ End-expiratory thickness)x100. The following values will be accepted for the results. Diaphragmatic Atrophy: Diaphragm thickness\<1-1.5cm Diaphragmatic thickness decreased by 10% compared to baseline Diaphragmatic Dysfunction: Diaphragmatic Thickening Fraction \<20
1.Duration of Mechanical Ventilation 2.Length of Stay in Intensive Care Unit
1. Definition: Total duration of mechanical ventilation received by the patient. Unit of Measure: Hours 2. Definition: Total length of stay in the intensive care unit. Unit of Measure: Days
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