Effects of Electrical Muscle Stimulation in Subjects Undergoing Prolonged Mechanical Ventilation
Effects of Electrical Muscle Stimulation in Subjects Undergoing Prolonged Mechanical Ventilation
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DOI：
10.4187/respcare.05921
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发表时间：
2019-03-01
期刊：
影响因子：
2.5
通讯作者：
Huang, Chung-Chi
中科院分区：
文献类型：
--
作者：
Chen, Yen-Huey;Hsiao, Hsiu-Feng;Huang, Chung-Chi
背景：肌肉萎缩和功能失调是长期机械通气（PMV）患者的常见并发症。很少有研究回顾了电肌肉刺激在这一人群中的作用。本研究的目的是检查肌肉电刺激对肌肉功能和住院结果的影响与PMV的主题。方法：将机械通气≥ 21 d的受试者随机分为肌肉电刺激组（n = 16）和对照组（n = 17）。肌肉电刺激组每日肌肉电刺激30 min/次，共10 d。在研究完成之前和之后，测量肌肉力量（通过医学研究理事会[MRC]量表）、腿围和身体功能状态（通过功能独立性测量[ADL]评分）。记录受试者在呼吸护理中心的住院时间。研究结果：肌肉电刺激后，肌肉电刺激组和对照组之间的肺功能没有差异。干预后，电肌肉刺激组的MRC分数显著增加（分别为2 [1-7]分vs 2 [1-3.5]分，P = 0.034）。对照组基线和测量后MRC评分无差异（分别为1[1-2]分和1[1-2.5]分，P > 0.99）。研究结束时，对照组的腿围与基线相比显著降低（分别为47.5 +/- 8.3 cm vs 44.6 +/- 5.7 cm，P = 0.004），EMS组保持不变。然而，电肌肉刺激和对照组之间没有显着差异。电肌肉刺激组和对照组之间的身体功能状态和住院时间没有差异。结论：电肌肉刺激增强了接受PMV的受试者的肌肉力量。电肌肉刺激可以被认为是接受PMV的患者肌无力的预防策略。
BACKGROUND: Muscle atrophy and deconditioning are common complications in patients on prolonged mechanical ventilation (PMV). There are few studies that reviewed the effects of electrical muscle stimulation in this population. The purpose of this study was to examine the effects of electrical muscle stimulation on muscle function and hospitalization outcomes in subjects with PMV. METHODS: Subjects on mechanical ventilation for >= 21 d were randomly assigned to the electrical muscle stimulation group (n = 16) or the control group (n = 17). The electrical muscle stimulation group received daily muscle electrical stimulation for 30 min/session for 10 d. The measurement of muscle strength (by medical research council [MRC] scale), leg circumference, and physical functional status (by Functional Independence Measure [FIM] scores) were performed before and after completion of the study. The length of stay in respiratory care center of subjects were recorded. RESULTS: After electrical muscle stimulation, there was no difference in pulmonary function between the electrical muscle stimulation and control groups. Significantly increased in MRC points was found in the electrical muscle stimulation group after intervention (2 [1-7] points vs 2 [1-3.5] points, respectively, P = .034). No difference in MRC points was found between baseline and post-measurement in the control group (1[1-2] points vs 1[1-2.5] points, respectively, P > .99). At the end of the study, leg circumference in control group significantly decreased when compared with baseline (47.5 +/- 8.3 cm vs 44.6 +/- 5.7 cm, respectively, P = .004) and remained unchanged in the EMS group. However, no significant differences were found between the electrical muscle stimulation and control groups. There was no difference in physical functional status and hospital stay between the electrical muscle stimulation and control groups. CONCLUSIONS: Electrical muscle stimulation enhanced muscle strength in subjects who received PMV. Electrical muscle stimulation can be considered a preventive strategy for muscle weakness in patients who receive PMV.