EFFICACY OF EXTERNAL DIAPHRAGM PACING SYSTEMS IN ATHLETES WITH TRACHEOSTOMIES: A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Objective: This systematic review and meta-analysis aimed to assess the effectiveness of external diaphragm pacing in enhancing rehabilitation outcomes for patients with tracheotomies. Methods: We searched multiple databases including PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) that evaluated the impact of external diaphragm pacing on patients with tracheotomies. The included studies compared outcomes between a control group receiving routine rehabilitation and an intervention group receiving both routine rehabilitation and external diaphragm pacing. Key outcomes analyzed included improvements in lung function, the incidence of pneumonia, and the success rate of extubation. Results: Our meta-analysis included nine RCTs, encompassing a total of 539 patients. The data showed that external diaphragm pacing significantly improved Maximal Inspiratory Pressure (MIP) in the treatment group compared to the control group (Mean Difference = 1.13 cm H2O; 95% Confidence Interval [0.5, 1.77]; P=0.0005). Moreover, the success rate of extubation was significantly higher in the intervention group (Odds Ratio = 3.02; 95% CI [1.83, 5.00]; P<0.0001). Conclusion: External diaphragm pacing significantly enhances respiratory function and increases the success rate of extubation in patients with tracheotomies, suggesting its potential as a beneficial rehabilitative intervention in this patient population. Further studies with larger sample sizes and diverse populations are recommended to confirm these findings.