Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Gerovasili V, Karatzanos E, Papadopoulos E, Renieris P, Bouchla A, Markaki V, Zervakis D, Routsi C, Nanas S. Int Care Med. 2007;33(Supp 2):S262. Abstract 1020.
Introduction: Recent studies have shown that electrical muscle stimulation (EMS) may be an alternative to active exercise in COPD and CHF patients with myopathy. A common finding in ICU patients is critical illness polyneuromyopathy (CIPNM). The role of EMS for the prevention of CIPNM in ICU patients has not been studied yet. The aim of our study was to assess the acute effect of EMS of lower extremities on the thenar muscle microcirculation in ICU patients using Near Infrared Spectroscopy (NIRS).
Methods: Eleven ICU patients (?6/?5),(age:56±18years)(APACHE admission score:15±6)(SOFA admission score 7±2),10 patients on mechanical ventilation (6 pts at VC mode/ 3 pts at PS/1 patient at T-piece) and 1 patient on venturi mask, underwent a 45-min session of EMS of vastus lateralis, vastus medialis and peroneus longus muscles of both lower extremities. The stimulator delivered biphasic, symmetric impulses of 45 Hz, 230ìsec pulse duration ,12 sec on and 6 sec off and an intensity of 40-80mA able to cause visible contractions. Systolic blood pressure(SBP) and heart rate(HR) were measured before and after each session in all patients. In eight patients arterial and central venous blood samples were retrieved before and after the session. Routine laboratory parameters were also recorded. Tissue oxygen saturation (StO2%) was assessed with NIRS at the thenar muscle before, during and after 3 min occlusion of the brachial artery before the beginning and after the completion of the EMS session.
Results: StO2% did not differ significantly before and after the EMS session (88±7%vs.89±9%). Oxygen consumption rate (%/min) during occlusion of the brachial artery differed significantly before the beginning and at the end of the session(19±6%/min vs.23±7%/min,p=0.004). Reperfusion rate (%/min) differed significantly before the beginning and at the end of the session (305±123%/min vs.378±139%/min, p=0.007). SBP and HR increased significantly at the end of the session (92bpm±16 vs 97bpm±15 p=0.002 and 135mmHg±23 vs 140±22mmHg, p=0.02 respectively).
Conclusion: The data presented suggest that EMS may have a systemic effect on microcirculation. These results may encourage further studies to explore the potential use of EMS as a possible preventive and rehabilitation tool in ICU patients with CIPNM.