Neuromuscular electrical stimulation may attenuate muscle proteolysis after cardiovascular surgery: A preliminary study
Neuromuscular electrical stimulation may attenuate muscle proteolysis after cardiovascular surgery: A preliminary study
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DOI：
10.1016/j.jtcvs.2016.09.036
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发表时间：
2017-02-01
影响因子：
6
通讯作者：
Yamada, Sumio
中科院分区：
文献类型：
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作者：
Iwatsu, Kotaro;Iida, Yuki;Yamada, Sumio
目的：为探讨术后神经肌肉电刺激（NMES）对心血管术后患者肌肉蛋白降解和肌无力的影响，对61例心血管术后患者在术后第1 ~ 5天（PODs）每天进行NMES（NMES组）和41例仅进行术后活动（非NMES组）。主要结局是POD 1至5的24小时尿中3-甲基组氨酸（3-MH）浓度，经尿肌酐含量（3-MH/Cre）校正。次要指标为术后第7天膝关节伸肌等长肌力（KEIS）和握力。结果：两组患者的年龄、性别、术前体重指数、血红蛋白、握力、KEIS、手术类型、体外循环时间和术后即刻白细胞介素-6等基线特征无差异。两组尿3-MH/Cre均显著升高，但NMES组尿3-MH/Cre峰值早于非NMES组。术后第7天，NMES组的KEIS显著更高（中位数[四分位距]，NMES组为0.40 kg/体重[0.33-0.45]，非NMES组为0.23 kg/体重[0.15-0.36]; P
Objective: To explore the efficacy of postoperative neuromuscular electrical stimulation (NMES) on muscle protein degradation and muscle weakness in patients after cardiovascular surgery.Methods: Sixty-one patients underwent NMES daily from postoperative days (PODs) 1 to 5 in addition to postoperative mobilization program (NMES group), and 41 patients underwent postoperative mobilization program only (non-NMES group). The primary outcome was the concentration of 3-methylhistidine (3-MH) in 24-hour urine corrected for urinary creatinine content (3-MH/Cre) from PODs 1 to 5. The secondary outcomes were knee extensor isometric strength (KEIS) and handgrip strength at POD 7.Results: Baseline characteristics such as age, sex, preoperative body mass index, hemoglobin, handgrip strength, KEIS, surgery type, cardiopulmonary bypass time, and immediate postoperative interleukin-6 were not different between the groups. Urinary 3-MH/Cre was increased significantly in both groups; however, urinary 3-MH/Cre in the NMES group peaked earlier compared with that in the non-NMES group. KEIS at POD 7 was significantly greater in the NMES group (median [interquartile range], 0.40 kg/weight [0.33-0.45] in the NMES group vs 0.23 kg/weight [0.15-0.36] in the non-NMES group; P