Hemodynamic effects of electrical muscle stimulation in the prophylaxis of deep vein thrombosis for intensive care unit patients: a randomized trial.
Hemodynamic effects of electrical muscle stimulation in the prophylaxis of deep vein thrombosis for intensive care unit patients: a randomized trial.
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DOI：
10.1186/s40560-016-0206-8
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发表时间：
2017
影响因子：
7.1
通讯作者：
Shimazu T
中科院分区：
文献类型：
--
作者：
Ojima M;Takegawa R;Hirose T;Ohnishi M;Shiozaki T;Shimazu T
深静脉血栓形成(DVT)是重症监护中的主要并发症。预防的方法多种多样，但都不能完全预防DVT，而且每种方法都有不良影响。电肌肉刺激(EMS)是预防重症监护病房(ICU)患者深静脉血栓形成的一种新的有效方法。我们推测，EMS增加了下肢的静脉血流量，对DVT的形成具有预防作用。这项研究包括26名住进单一ICU的患者。我们招募了因脊髓损伤、头部损伤、中枢神经系统异常和镇静进行机械通气而无法活动的患者。患者被随机分为EMS组和对照组。EMS组患者在入院后14天内，在任意天数内接受30分钟的EMS敷贴于双侧下肢。对照组患者不接受EMS治疗。超声测量股总静脉(CFV)和月国静脉(Pop.V)的峰值血流速度和内径，并用公式计算血流量。除死亡率外，两组患者的特征在统计学上没有显著差异。EMS组Pop.V和CFV血流速度的中位数和四分位数范围(IQR，第25~75百分位数)分别为10.6(8.0~14.8)比24.5(15.1~37.8)cm/S和17.0(12.3~23.8)比24.3(17.0~33.0)cm/S(p <； 0.05)。静息状态和急诊状态下静脉血流量的中位数(IQR)分别为4.2(2.7~7.2)和8.6(5.4~16.1)cm~3/S和12.9(9.7~2 1.4)和2 0.8(12.3~34.1)cm~3/S(p <； 0.05)。未发现与EMS相关的主要并发症。EMS增加了下肢静脉血流量。EMS可能是一种潜在的静脉血栓预防方法。UMIN000013642
Deep vein thrombosis (DVT) is a major complication in critical care. There are various methods of prophylaxis, but none of them fully prevent DVT, and each method has adverse effects. Electrical muscle stimulation (EMS) could be a new effective approach to prevent DVT in intensive care unit (ICU) patients. We hypothesized that EMS increases the venous flow of the lower limbs and has a prophylactic effect against the formation of DVT. This study included 26 patients admitted to a single ICU. We enrolled patients who could not move themselves due to spinal cord injury, head injury, central nervous system abnormalities, and sedation for mechanical ventilation. The patients were randomly allocated to either the EMS group or the control group. Patients in the EMS group received 30-min sessions of EMS applied to the bilateral lower extremities on arbitrary days within 14 days after admission. The control patients received no EMS. The peak flow velocity and diameter of the popliteal vein (Pop.V) and common femoral vein (CFV) were measured by ultrasound and then the volumes of venous flow were calculated using a formula. There were no statistically significant differences in patient characteristics between the two groups except for the mortality rate. In the EMS group, the median and interquartile range (IQR, 25th–75th percentile) of velocities of the Pop.V and CFV were higher during EMS compared with at rest: 10.6 (8.0–14.8) vs 24.5 (15.1–37.8) cm/s and 17.0 (12.3–23.8) vs 24.3 (17.0–33.0) cm/s, respectively (p < 0.05). The median (IQR) of volumes of venous flow of the Pop.V and CFV at rest and during EMS were 4.2 (2.7–7.2) vs 8.6 (5.4–16.1) cm3/s and 12.9 (9.7–21.4) vs 20.8 (12.3–34.1) cm3/s, respectively (p < 0.05). There were no major complications related to EMS. EMS increased the venous flow of the lower limbs. EMS could be one potential method for venous thromboprophylaxis. UMIN000013642