Effects of neuromuscular electrical stimulation in critically ill patients: A systematic review and meta-analysis of randomised controlled trials
| Autor: | Adam Chahine, Babikir Kheiri, Mahmoud Barbarawi, Laith Rashdan, Ghassan Bachuwa, Sai Chintalapati, Ibrahim Al-Sanouri, Yazan Zayed |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Critical Care Critical Illness medicine.medical_treatment Emergency Nursing Cochrane Library Critical Care Nursing law.invention 03 medical and health sciences 0302 clinical medicine law medicine Humans 030212 general & internal medicine Myopathy Aged Randomized Controlled Trials as Topic Mechanical ventilation Muscle Weakness Rehabilitation business.industry 030208 emergency & critical care medicine Length of Stay Middle Aged Intensive care unit Electric Stimulation Confidence interval Intensive Care Units Relative risk Meta-analysis Emergency medicine Female medicine.symptom business |
| Zdroj: | Australian Critical Care. 33:203-210 |
| ISSN: | 1036-7314 |
| DOI: | 10.1016/j.aucc.2019.04.003 |
| Popis: | Objectives We performed a systematic review and meta-analysis to examine the effect of neuromuscular electrical stimulation (NES) on prevention of critical care myopathy and its effect on various clinical outcomes in the intensive care unit (ICU). Review methods used This study involved systematic review and meta-analysis of randomised controlled trials (RCTs) comparing NES (applied to different muscle groups combined with usual care) and usual care (passive and active exercises along with early mobilisation and rehabilitation). Included studies enrolled adult patients managed in the ICU for medical or surgical diseases who were or were not mechanically ventilated. The primary outcome was global muscle strength measured by the Medical Research Council grading system. Secondary outcomes included ICU mortality, duration of mechanical ventilation (MV), and ICU length of stay. Risk ratio for dichotomous data and mean difference (MD) for continuous data with their corresponding 95% confidence interval (CI) were calculated. Data source A search in major electronic databases, including PubMed, Cochrane Library, and Embase, from inception to November 2018 was carried out. Results Six RCTs were included, representing 718 patients. The mean age 60 ± 15.3 years, and 60.6% were male. There was no significant difference between NES and usual care on global muscle strength measured by Medical Research Council grading system (MD: 0.45; 95% CI: −2.89 to 3.80; p = 0.79), ICU mortality (risk ratio: 1.30; 95% CI: 0.95–1.78; p = 0.10), duration of MV (days) (MD: -2.07; 95% CI: −5.06 to 0.92; p = 0.18), or ICU length of stay (days) (MD: -3.06; 95% CI: -9.79 to 3.68; p = 0.37) in comparison with the usual therapy alone in critically ill patients. Conclusion NES combined with usual care was not associated with significant differences in global muscle strength, ICU mortality, duration of MV, or ICU length of stay in comparison with usual care alone in critically ill patients. Further RCTs are needed to determine patients with maximum benefit and to examine NES safety and efficacy. |
| Databáze: | OpenAIRE |
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