New Device at UToledo Health Helping Critically Ill Patients Get Off Ventilators Faster

UToledo Health is first in the region to offer the LungPacer AeroPace® Neurostimulation System, an FDA-approved therapy proven to get critically ill patients off ventilators faster.

The AeroPace System addresses an issue seen in intensive care units daily. When a patient is on mechanical ventilation, their diaphragm, the primary muscle responsible for breathing, is no longer working. Because the diaphragm is a muscle in constant use, it atrophies rapidly, sometimes within 12 hours of ventilation.

"That muscle is very important to your work of breathing, and you don't really get to work it when you're on a ventilator," said Melissa Kukiela, director of respiratory care at UTMC. "As that muscle atrophies, it becomes more difficult for the patient to come off the ventilator."

When a patient is unable to successfully wean from the ventilator, the consequences compound. Failed weaning can lead to reintubation and extended ventilator time, both of which increase the risk of pneumonia, infections, pressure injuries and other serious complications. The stakes are even higher for older patients or those with pre-existing conditions.

"It gets even more dangerous as we get older because we have less muscle mass," said Dr. Jill Cherry-Bukowiec, trauma surgery and surgical critical care physician at UTMC. "If you have someone who is elderly, fell and broke a hip, and couldn't get off the ventilator for the first day, they have a real risk of potentially being on long-term ventilation and even needing a tracheostomy."

The AeroPace System addresses this directly while the ICU patient is still ventilated. The system uses targeted electrical stimulation delivered through a central venous catheter, a line most ICU patients already require. Through the catheter, the system directly stimulates the phrenic nerve, which activates the diaphragm.

This is done in two, 15-minute sessions daily. The stimulation strengthens the diaphragm while the patient is ventilated, allowing them to breathe on their own faster than traditional recovery methods.

The intensive care unit at the University of Toledo Medical Center is now equipped with the AeroPace System, placing the hospital ahead of local and regional hospital systems in adopting a technology that clinical trials show can reduce time on a ventilator by an average of 3.2 days and lower the risk of reintubation by 47%.

Clinical data from the RESCUE-3 randomized controlled trial, published in the American Journal of Respiratory and Critical Care Medicine, demonstrated that patients treated with AeroPace experienced 43% faster weaning from mechanical ventilation, 74% greater diaphragm strength and a 50% lower risk of tracheostomy compared to standard care. The system received FDA premarket approval in December 2024, making it the first device of its kind cleared for this use.

"At UToledo Health, we are committed to getting our most critically ill patients home to their families as quickly and safely as possible," said Russell Smith, chief operating officer of UTMC. "The LungPacer AeroPace System is a meaningful step toward that goal, reducing time on mechanical ventilation and helping patients recover faster in the ICU."

"I was extremely excited to hear there might be an intervention that could help us prevent patients from needing a tracheostomy and also get them off the ventilator earlier, which means getting them back home or to rehab faster, so they can get better and back to their families," Cherry-Bukowiec said.

Kukiela said UToledo Health is currently collecting data on outcomes of patients who undergo therapy with the device. She believes the device should become a regular tool for her team.

"Any day on a ventilator is too long as far as we're concerned," she said. "And with this new device, it takes very little time for a very big outcome."