Safety and feasibility of a functional electrical stimulation cycling-based muscular dysfunction diagnostic method in mechanically ventilated patients.

Autor: Figueiredo T; Pernambuco University Heart Hospital/University of Pernambuco, Recife, Brazil., Frazão M; Lauro Wanderley University Hospital, Federal University of Paraíba, João Pessoa, Brazil.; CLINAR Exercise Physiology, João Pessoa, Brazil., Werlang LA; INBRAMED-Brazilian Medical Equipment Industry, Porto Alegre, Brazil., Kunz A; INBRAMED-Brazilian Medical Equipment Industry, Porto Alegre, Brazil., Peltz M; INBRAMED-Brazilian Medical Equipment Industry, Porto Alegre, Brazil., Furtado VC; Pernambuco University Heart Hospital/University of Pernambuco, Recife, Brazil., Júnior EB; Pernambuco University Heart Hospital/University of Pernambuco, Recife, Brazil., Júnior JM; Pernambuco University Heart Hospital/University of Pernambuco, Recife, Brazil., Silva RM; Pernambuco University Heart Hospital/University of Pernambuco, Recife, Brazil., Sobral Filho DC; Pernambuco University Heart Hospital/University of Pernambuco, Recife, Brazil.
Jazyk: angličtina
Zdroj: Artificial organs [Artif Organs] 2024 Jul; Vol. 48 (7), pp. 713-722. Date of Electronic Publication: 2024 Feb 23.
DOI: 10.1111/aor.14734
Abstrakt: Background: A nonvolitional diagnostic method based on FES-Cycling technology has recently been demonstrated for mechanically ventilated patients. This method presents good sensitivity and specificity for detecting muscle dysfunction and survival prognosis, even in unconscious patients. As the clinical relevance of this method has already been reported, we aimed to evaluate its safety and feasibility.
Methods: An observational prospective study was carried out with 20 critically ill, mechanically ventilated patients. The FES-cycling equipment was set in a specific diagnostic mode. For safety determination, hemodynamic parameters and peripheral oxygen saturation were measured before and immediately after the diagnostic protocol, as well as venous oxygen saturation and blood lactate. The creatine phosphokinase level (CPK) was measured before and 24, 48, and 72 h after the test. The time taken to carry out the entire diagnostic protocol and the number of patients with visible muscle contraction (capacity of perceptive muscular recruitment) were recorded to assess feasibility.
Results: Heart rate [91 ± 23 vs. 94 ± 23 bpm (p = 0.0837)], systolic [122 ± 19 vs. 124 ± 19 mm Hg (p = 0.4261)] and diastolic blood pressure [68 ± 13 vs. 70 ± 15 mm Hg (p = 0.3462)], and peripheral [98 (96-99) vs. 98 (95-99) % (p = 0.6353)] and venous oxygen saturation [71 ± 14 vs. 69 ± 14% (p = 0.1317)] did not change after the diagnostic protocol. Moreover, blood lactate [1.48 ± 0.65 vs. 1.53 ± 0.71 mmol/L (p = 0.2320)] did not change. CPK did not change up to 72 h after the test [99 (59-422) vs. 125 (66-674) (p = 0.2799) vs. 161 (66-352) (p > 0.999) vs. 100 (33-409) (p = 0.5901)]. The time taken to perform the diagnostic assessment was 11.3 ± 1.1 min. In addition, 75% of the patients presented very visible muscle contractions, and 25% of them presented barely visible muscle contractions.
Conclusions: The FES cycling-based muscular dysfunction diagnostic method is safe and feasible. Hemodynamic parameters, peripheral oxygen saturation, venous oxygen saturation, and blood lactate did not change after the diagnostic protocol. The muscle damage marker (CPK) did not increase up to 72 h after the diagnostic protocol.
(© 2024 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)
Databáze: MEDLINE
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