Safety in application of neuromuscular electrical stimulation in critically ill patients: pilot study

Abstract

BACKGROUND: Neuromuscular Electrical Stimulation (NMES) is an important ally of the critically ill patient, favoring active contractions even when in a state that requires immobility. OBJECTIVE: The objective of this study was to verify the safety of NMES application in Intensive Care Units (ICUs) of a public hospital in the city of Salvador. MATERIAL AND METHODS: This is a pilot, study of intervention. Data were collected from February to June 2018, having as population critically ill intubated patients using vasopressors. A single 45-minute NMES session was applied to both quadriceps (rectus femoris and vastus lateralis), and the following hemodynamic data were collected 5 minutes before application and soon after therapy: cardiac frequency, systolic, diastolic and medium blood pressure and respiratory frequency. Data were collected following security recommandations, described earlier. For statistical analysis, the variables were described by mean and standard deviation, median and interquartile interval and percentages obtained for the variables of the study. The distribution of data was evaluated by the Shapiro-Wilk test and Mann Whitney test and t test were used. RESULTS: The sample consisted of 8 patients, being 1 excluded. Of these, 85.7% were female, with a clinical diagnosis of Sepsis in 85.7%, mean age of 61±9.5 years and APACHE II of 29±5.5. No statistical differences were observed in relation to hemodynamic data collected before and after electrostimulation. These data are similar to those found by other authors in populations without vasopressors usage. CONCLUSION: It is possible to suggest that the application of NMES in critically ill patients using vasopressors is a safe and viable technique as long as respecting the established limits and correct evidence-based parameters.