Efficacy of neuromuscular electrical stimulation in patients with COPD followed in intensive care unit


Akar O., Günay E., Sarinc Ulasli S., ULAŞLI A. M. , Kacar E., Sariaydin M., ...More

Clinical Respiratory Journal, vol.11, no.6, pp.743-750, 2017 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 11 Issue: 6
  • Publication Date: 2017
  • Doi Number: 10.1111/crj.12411
  • Title of Journal : Clinical Respiratory Journal
  • Page Numbers: pp.743-750
  • Keywords: chronic obstructive pulmonary disease, inflammation, intensive care, neuromuscular electrical stimulation, pulmonary rehabilitation, weaning, CRITICALLY-ILL PATIENTS, OBSTRUCTIVE LUNG-DISEASE, NECROSIS-FACTOR-ALPHA, MUSCLE STIMULATION, MECHANICAL VENTILATION, EXERCISE, REHABILITATION, WEAKNESS, TRIAL

Abstract

© 2015 John Wiley & Sons LtdIntroduction: Serious problems on muscle strength and functional status can be seen in bedridden-patients with chronic obstructive pulmonary diseases (COPD) receiving mechanical ventilation. We aimed to investigate the impact of active extremity mobilization and neuromuscular electrical stimulation (NMES) on weaning processes, discharge from hospital and inflammatory mediators in COPD patients receiving mechanical ventilation. Methods: Thirty conscious COPD patients (F/M:15/15) hospitalized in the intensive care unit (ICU) with diagnosis of respiratory failure were enrolled to this study. Patients were randomized into three groups, including 10 patients for each. Active extremity-exercise training and NMES were applied to Group-1, only NMES was applied to Group-2 and active extremity exercise training was applied to Group-3. Muscle strengths, mobilization duration and weaning situation were evaluated. Serum cytokine levels were evaluated. Results: Lower extremity muscle-strength was significantly improved in Group-1 (from 3.00 to 5.00, P = 0.014) and 2 (from 4.00 to 5.00, P = 0.046). Upper extremity muscle strength was also significantly improved in all three groups (from 4.00 to 5.00 for all groups, P = 0.038, P = 0.046 and P = 0.034, respectively). Duration of mobilization and discharge from the ICU were similar among groups. There was a significant decrease in serum interleukin (IL)-6 level in Group-1 and in serum IL-8 level in Group-1 and Group-2 after rehabilitation. Conclusion: This study indicates that pulmonary rehabilitation can prevent loss of muscle strength in ICU. Nevertheless, we consider that further studies with larger populations are needed to examine the impact of NMES and/or active and passive muscle training in bedridden ICU patients who are mechanically ventilated.