Clinical Research Directory

Multimodal Assessment of NMES Effects on Respiratory and Peripheral Muscles in COPD

The goal of this clinical trial is to learn if targeted neuromuscular electrical stimulation (NMES) can treat respiratory and peripheral muscle weakness in patients with chronic obstructive pulmonary disease (COPD). The main questions it aims to answer are: * Does targeted NMES improve diaphragm thickening fraction and excursion as measured by diaphragm ultrasound? * What are the comparative effects of targeted NMES on plasma biomarkers, specifically Interleukin-6 (IL-6) and Insulin-like Growth Factor-1 (IGF-1)? Researchers will compare three groups: the first intervention group receiving intercostal NMES combined with Pursed-Lip Breathing (PLB), the second intervention group receiving quadriceps NMES combined with PLB, and a control group receiving sham upper trapezius NMES combined with PLB, to see if targeted NMES provides superior improvements in respiratory and peripheral muscle function. Participants will: * Undergo baseline screening, including a diaphragm ultrasound and a blood draw for plasma biomarkers (IL-6 and IGF-1) * Be randomly assigned to one of the three groups to receive either intercostal NMES, quadriceps NMES, or sham upper trapezius NMES, all combined with Pursed-Lip Breathing exercises * Complete a post-intervention assessment involving repeat ultrasound imaging and biomarker analysis to evaluate muscle and systemic changes

Ultrasound Evaluation of Respiratory Muscles During Mechanical Ventilation Weaning in ICU Patients

Patients with pneumonia who require invasive mechanical ventilation in the intensive care unit (ICU) often experience difficulties during the process of being separated from the breathing machine (weaning). Failure of weaning is associated with longer ventilation duration, prolonged ICU stay, and increased risk of complications and death. Therefore, simple and reliable bedside tools are needed to better understand respiratory muscle function and to help predict weaning outcomes. This prospective, observational, single-center study aims to evaluate respiratory muscle function using bedside ultrasound in adult ICU patients with pneumonia receiving invasive mechanical ventilation. The diaphragm, parasternal intercostal muscles, and anterior scalene muscles will be assessed using ultrasound during the weaning process. Measurements will be performed serially, starting from the first day when patients demonstrate meaningful spontaneous breathing effort and continuing until successful extubation, tracheostomy, or ICU mortality. Ultrasound measurements of muscle thickness and thickening fraction will be analyzed in relation to weaning outcomes. In addition, ventilator parameters and commonly used weaning indices will be recorded at the time of each ultrasound assessment. The findings of this study are expected to improve understanding of respiratory muscle involvement during weaning and may contribute to earlier identification of patients at risk of weaning failure.