The effect of neuromuscular electrical stimulation on mechanically ventilated patients in the ICU

NMES for mechanically ventilated patients in ICU has a significant effect on muscle strength, handgrip strength, mechanical ventilation time, ICU stay time, ICU mortality rate.

Long-term use of ventilators, sedatives, and immobilization may be the risk factors and reasons for ICU acquired weakness (ICUAW). ICUAW might occur within a few hours after mechanical ventilation, patients have to cope with difficulty on weaning, limb paralysis, weakened reflexes, and muscle atrophy. ICUAW patients often cannot fully recover and suffer from severe dysfunction that can affect the quality of life of survivors.

The mechanism, clinical diagnosis, and treatment of ICUAW are still in the stage of continuous exploration. Therefore, attention should be paid to the prevention of ICUAW.

Some studies conducted a systematic evaluation of the effect of early activities on mechanically ventilated patients. It was found that the differences in specific measures of early activities included in these studies were the reason for the heterogeneity of the combined results. As one of the measures of early activities. NMES (Neuromuscular Electrical Stimulation) research results are merged. Many countries have used it alone as a way to maintain the muscle strength of mechanically ventilated patients. Research results show that NMES represents an effective and feasible intervention that can prevent skeletal muscle atrophy in ICU coma patients.

In addition, most systematic reviews have hardly assessed the appropriateness of the protocols or parameters used by NMES(Neuromuscular Electrical Stimulation) in a single study, thus provided little guidance on the best parameters and application techniques for specific therapeutic interventions. The application of NMES requires Considering its safety, the electrodes directly attached to the patient’s skin can easily cause skin rashes, allergies, burns, and other common adverse reactions. This study aims to systematically evaluate the application effect of NMES in mechanically ventilated patients in ICU and provide a reference for future research on the potential benefits and safety of NMES as a rehabilitation strategy.

The effect of NMES on preventing ICUAW

NMES (Neuromuscular Electrical Stimulation can effectively improve the muscle strength of ICU patients, shorten the time of mechanical ventilation, ICU hospitalization, and total hospitalization, improve the patient’s ability of daily living, and increase the walking distance during discharge. NMES can to some extent reduce related risk factors. To achieve the effect of preventing ICUAW, it is especially suitable for mechanically ventilated patients with impaired consciousness and unable to get out of bed in the early stage of coma.

ICU acquired muscle weakness can complicate the course of critically ill patients and seriously affect the prognosis of ICU patients. Among them, limb weakness can increase the patient’s bedtime and complications; respiratory muscle weakness can prolong the patient’s ventilator offline time by 2 to 7 times, and the failure rate of tracheal intubation and extubating increases. This treatment can effectively improve the muscle strength of the limbs in ICU patients, but the respiratory muscles of the patients do not have a good rehabilitation effect.

Respiratory Neuromuscular Stimulator performs synergistic feedback electrical stimulation for the most important inspiratory muscle (diaphragm) and the most important expiratory muscle (abdominal muscle). Stimulating physical therapy makes the diaphragm and abdominal muscles contract regularly, gradually increase the strength and endurance of the respiratory muscles, help the patients with acquired frailty in the ICU to withdraw from the machine, and shorten the length of stay in the ICU.