Effects of Abdominal Electrical Stimulation Combined With Airway Clearance Techniques in Tracheotomized Patients With Neurological Disorders: A Randomized, Controlled Trial
In brief
Abdominal electrical stimulation raises decannulation success from 73% to 93%
In a randomized trial of 68 tracheostomized neurologic patients, adding abdominal electrical stimulation to standard airway clearance increased successful decannulation to 93% versus 73% with airway clearance alone, while also improving cough flow and abdominal muscle thickness. Infection scores and diaphragm movement were unchanged, leaving the impact on pulmonary complications uncertain.
- Journal
- Critical care medicine (Q1)
- Published
- 17 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Feixiang Huo, Haidong Xu, Shiguang Shao, Yalu Sun, Hongrui Zhang, Wanguang Jia, et al.
- PMID
- 42467907
- DOI
- 10.1097/CCM.0000000000007267
Why clinicians should know about it
- Picked for Emergency Medicine (top studies of the week, 19 July 2026).
- Picked for Critical Care and Intensive Care Medicine (paper of the day, 18 July 2026): Abdominal electrical stimulation RCT in tracheostomized patients
- Picked for Pulmonary and Respiratory Medicine (paper of the day, 18 July 2026).
Abstract
OBJECTIVES: This study aims to investigate the effects of combined abdominal electrical stimulation and airway clearance techniques on the primary outcome of decannulation success in tracheostomized patients with neurologic disorders. DESIGN: A randomized, assessor-blinded, controlled trial. SETTING: Department of Rehabilitation Medicine, Affiliated Hospital of Jining Medical University. PATIENTS: A total of 68 adult patients with neurologic disorders who had successfully weaned off mechanical ventilation but remained tracheostomized participated in this study. INTERVENTIONS: Airway clearance techniques with or without abdominal electrical stimulation therapy. MEASUREMENTS AND MAIN RESULTS: We randomized 68 patients into control (n = 34) and experimental (n = 34) groups. Both groups received a 6-week course of conventional treatment combined with airway clearance techniques. The experimental group additionally received abdominal electrical stimulation. The primary outcome was the decannulation success rate. Secondary outcomes assessed over 6 weeks included peak flow rate during nonvoluntary coughing, clinical pulmonary infection score, abdominal muscle thickness, and resting diaphragmatic mobility. At 6 weeks, the experimental group demonstrated significantly higher peak involuntary cough flow rate (mean difference, 39.433 L/min; 95% CI, 28.83-50.04; p < 0.001) and abdominal muscle thickness (difference, 0.106 cm; 95% CI, 0.08-0.13; p < 0.001) compared with the control. Furthermore, the decannulation success rate was significantly higher in the experimental group (93.3%) than that in the control group (73.3%; odds ratio, 5.070; 95% CI, 1.41-18.24; p = 0.013). However, no significant differences were observed between the two groups in clinical pulmonary infection scores (p > 0.05) or resting diaphragm mobility (p > 0.05). CONCLUSIONS: Adding abdominal electrical stimulation to airway clearance techniques significantly improves cough efficacy, increases abdominal muscle thickness, and enhances decannulation success in tracheostomized patients with neurologic disorders. However, it does not appear to alter infection control or resting diaphragmatic activity.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.