Neuromuscular Electrical Stimulation As a Possible Means to Prevent Muscle Tissue Wasting in Artificially Ventilated and Sedated Patients in the Intensive Care Unit: A Pilot Study

Meesen, Raf; Dendale, Paul; Cuypers, Koen; Berger, Jan; Hermans, Annelies; Thijs, Herbert; Levin, Oron

doi:10.1111/j.1525-1403.2010.00294.x

Cited by 50 publications

(91 citation statements)

References 38 publications

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“…In non-ICU patient populations, EMS has been shown to increase muscle strength and exercise tolerance (637). Preliminary results in small samples of critically ill patients were promising and found that EMS preserved muscle mass (237,272,474), reduced muscle catabolism (73), and exerted shortterm systemic microcirculatory effects (238). In another eight patients with septic shock however, 7 days of EMS did not preserve muscle volume (555).…”

Section: Electrical Muscle Stimulationmentioning

confidence: 92%

The Sick and the Weak: Neuropathies/Myopathies in the Critically Ill

Friedrich

Reid

Berghe

et al. 2015

Physiological Reviews

300

329

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Critical illness polyneuropathies (CIP) and myopathies (CIM) are common complications of critical illness. Several weakness syndromes are summarized under the term intensive care unit-acquired weakness (ICUAW). We propose a classification of different ICUAW forms (CIM, CIP, sepsis-induced, steroid-denervation myopathy) and pathophysiological mechanisms from clinical and animal model data. Triggers include sepsis, mechanical ventilation, muscle unloading, steroid treatment, or denervation. Some ICUAW forms require stringent diagnostic features; CIM is marked by membrane hypoexcitability, severe atrophy, preferential myosin loss, ultrastructural alterations, and inadequate autophagy activation while myopathies in pure sepsis do not reproduce marked myosin loss. Reduced membrane excitability results from depolarization and ion channel dysfunction. Mitochondrial dysfunction contributes to energy-dependent processes. Ubiquitin proteasome and calpain activation trigger muscle proteolysis and atrophy while protein synthesis is impaired. Myosin loss is more pronounced than actin loss in CIM. Protein quality control is altered by inadequate autophagy. Ca 2ϩ dysregulation is present through altered Ca 2ϩ homeostasis. We highlight clinical hallmarks, trigger factors, and potential mechanisms from human studies and animal models that allow separation of risk factors that may trigger distinct mechanisms contributing to weakness. During critical illness, altered inflammatory (cytokines) and metabolic pathways deteriorate muscle function. ICUAW prevention/treatment is limited, e.g., tight glycemic control, delaying nutrition, and early mobilization. Future challenges include identification of primary/secondary events during the time course of critical illness, the interplay between membrane excitability, bioenergetic failure and differential proteolysis, and finding new therapeutic targets by help of tailored animal models.

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Section: Electrical Muscle Stimulationmentioning

confidence: 92%

The Sick and the Weak: Neuropathies/Myopathies in the Critically Ill

Friedrich

Reid

Berghe

et al. 2015

Physiological Reviews

300

329

View full text Add to dashboard Cite

show abstract

“…This review included eight RCTs (15,(34)(35)(36)(37)(38)(39)(40) and one casecontrol study (41). Evaluation of EMS in the ICU is a rapidly growing area of research as evidenced by 40% of the reviewed studies being published within the past year (15,35,40).…”

Section: Study Characteristicsmentioning

confidence: 99%

Electrical Muscle Stimulation in the Intensive Care Setting

Parry

Berney

Granger

et al. 2013

Critical Care Medicine

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“…Patients who stay in bed for long periods of time are prone to develop skeletal muscle weakness, leading to muscle atrophy and a loss of 3-11% of muscle mass in the first 3 weeks of immobilization (7). Such loss of muscle mass and muscle weakness are caused by acquired myopathy, polyneuropathy, or a combination of both (8).…”

mentioning

confidence: 99%

Use of neuromuscular electrical stimulation to preserve the thickness of abdominal and chest muscles of critically ill patients: A randomized clinical trial

Acqua¹,

Sachetti²,

Santos³

et al. 2017

J Rehabil Med

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Objective: To evaluate and compare the effects of neuromuscular electrical stimulation combined with conventional physical therapy on muscle thickness in critically ill patients. Design: Double-blind, randomized controlled trial. Patients: Twenty-five patients participated in the study. Methods: Patients on mechanical ventilation for 24-48 h were randomized to an intervention group (neuromuscular electrical stimulation + conventional physical therapy) or a conventional group (sham neuromuscular electrical stimulation + conventional physical therapy). Primary outcome was thickness of the rectus abdominis and chest muscles, determined on cross-sectional ultrasound images before and after the intervention. Results: Eleven patients were included in the intervention group and 14 in the conventional group. After neuromuscular electrical stimulation, rectus abdominis muscle thickness and chest muscle thickness were preserved in the intervention group, whereas there was a significant reduction in thickness in the conventional group, with a significant difference between groups. There was a significant difference between groups in length of stay in the intensive care unit, with shorter length of stay in the intervention group. Conclusion: There was no change in rectus abdominis and chest muscle thickness in the intervention group. A significant decrease was found in these measures in the conventional group.

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Neuromuscular Electrical Stimulation As a Possible Means to Prevent Muscle Tissue Wasting in Artificially Ventilated and Sedated Patients in the Intensive Care Unit: A Pilot Study

Cited by 50 publications

References 38 publications

The Sick and the Weak: Neuropathies/Myopathies in the Critically Ill

The Sick and the Weak: Neuropathies/Myopathies in the Critically Ill

Electrical Muscle Stimulation in the Intensive Care Setting

Use of neuromuscular electrical stimulation to preserve the thickness of abdominal and chest muscles of critically ill patients: A randomized clinical trial

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