Extracorporeal pacing stimulation enhancing diaphragmatic function of patients after single-pole video assisted lobectomy: A single-blinded RCT

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Abstract Background The extracorporeal diaphragmatic pacemaker(EDP),known for its ability to prevent diaphragmatic muscle function decline in chronic and critically ill patients.However,it remains uncertain whether EDP can effectively enhance pulmonary function in patients after surgery. Objective This study aims to determine whether EDP can quickly recover the diaphragm function of lung cancer patients after surgery to improve pulmonary function. Methods This study was designed as a single-blinded randomized controlled trial(RCT).Patients who met the inclusion criteria were randomly divided into two groups.The EDP group received additional EDP stimulation.The primary outcome measures were included diaphragm thickening fraction(DTF),diaphragm thickness at the end of inspiration (DTei),diaphragm excursion(DE),measured on the admission day(T0),the first day after surgery(T1), the day when the thoracic drainage tube was removed(T2).The secondary outcome measures included postoperative complications,chest tube indwelling hours,and visual analog scale(VAS) assessment measured at T1 and T2. Results 78 patients were enrolled,with 39 in the EDP group and 39 in the control group.Both groups demonstrated a significant postoperative decrease in DE and DTei(T1 < T0,EDP group P = 0.000;control group P = 0.000).Following the EDP treatment intervention,the EDP group showed a notable increase in DE and DTei(T2 > T1,P = 0.000;P = 0.000),and the control group also exhibited significant changes in DE and DTei(T2 > T1,P = 0.000;P = 0.005).However,at the T2 time point,there was a statistically significant difference in DE between the EDP group and the control group(P = 0.049).Notably,the EDP group's DTei at the T2 time point recovered to the level of the T0 time point,with no significant difference between the two time points(P = 0.096).Differences in the control group Dtei at the T2 time point compared to the T0 time point(P = 0.000),postoperative complications and chest tube indwelling hours showed no significant differences between the two groups.Statistical significance was found at T2,with the EDP group having a lower VAS value(1.00 ± 0.513 vs1.31 ± 0.521,P = 0.028). Conclusion EDP can significantly improve early diaphragm excursion and reduce pain perception in patients after SPVATS.It is beneficial for accelerating postoperative rehabilitation in lung cancer patients.EDP holds promise for clinical application and merits further clinical promotion. Trial registration: The study is registered in the Chinese Clinical Trial (ChiCTR2300072733).

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