SynthesisBMJ open2025
Consequences in critically ill patients with prolonged mechanical ventilation after diaphragmatic stimulation techniques: a systematic review and meta-analysis.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Effects of Phrenic Nerve Stimulation in Mechanically Ventilated Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of clinical medicine · 2026Review
- Diaphragm stimulation in critically ill patients: what do we know, and what do we still need to learn?Einstein (Sao Paulo, Brazil) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveProlonged mechanical ventilation (MV) may lead to poor outcomes. This systematic review and meta-analysis aimed to investigate the effects of diaphragmatic stimulation on the duration of MV (DMV), the intensive care unit (ICU) length of stay (ILOS), the proportion of patients successfully weaned and maximum inspiratory pressure (MIP) in patients with prolonged MV.
designSystematic review and meta-analysis. DATA SOURCES: Cochrane library, Embase, Pubmed and Web of Science up to December 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials (RCTs) and cohort studies evaluating the outcomes of patients with prolonged MV after diaphragmatic stimulation were included up to December 2024. DATA EXTRACTION AND SYNTHESIS: All articles were independently assessed by two reviewers, and a third reviewer was consulted to resolve different evaluations. Newcastle-Ottawa Scale (NOS) and the Cochrane Collaboration tool in RevMan V.5.3 software (The Cochrane Collaboration, 2014) were applied to assess the quality of cohort studies or RCTs. The meta-analysis was carried out with RevMan V.5.3 software, applying a random-effects model and presenting results with 95% CIs. Heterogeneity was examined using the Higgins I² statistic, and subgroup analyses were carried out to investigate possible contributors to heterogeneity. Sensitivity analyses were further conducted in Stata 18.0 (StataCorp LP, College Station, TX, USA). Potential publication bias was assessed through funnel plots combined with Egger's regression test. For each outcome, the certainty of evidence was appraised according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
resultsTen studies involving 802 patients (349 received diaphragmatic stimulation) were included. The meta-analysis indicated that patients receiving diaphragmatic stimulation had shorter DMV (mean differences (MD) -5.69 d, 95% CI -10.99 to -0.39, p=0.04) and ILOS (MD -5.48 d, 95% CI -10.72 to -0.24, p=0.04). The proportion of patients successfully weaned was larger in patients with diaphragmatic stimulation (risk ratios (RR) 1.25, 95% CI 1.01 to 1.53, p=0.04). The MIP increased compared with the control group.
conclusionsThe promising results suggest that diaphragmatic stimulation has the potential to shorten DMV and ILOS and accelerate weaning from ventilator. PROSPERO REGISTRATION NUMBER: CRD42024599512.
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