Abstract：
BACKGROUND: A nonvolitional diagnostic method based on FES-Cycling technology has recently been demonstrated for mechanically ventilated patients. This method presents good sensitivity and specificity for detecting muscle dysfunction and survival prognosis, even in unconscious patients. As the clinical relevance of this method has already been reported, we aimed to evaluate its safety and feasibility.
METHODS: An observational prospective study was carried out with 20 critically ill, mechanically ventilated patients. The FES-cycling equipment was set in a specific diagnostic mode. For safety determination, hemodynamic parameters and peripheral oxygen saturation were measured before and immediately after the diagnostic protocol, as well as venous oxygen saturation and blood lactate. The creatine phosphokinase level (CPK) was measured before and 24, 48, and 72 h after the test. The time taken to carry out the entire diagnostic protocol and the number of patients with visible muscle contraction (capacity of perceptive muscular recruitment) were recorded to assess feasibility.
RESULTS: Heart rate [91 ± 23 vs. 94 ± 23 bpm (p = 0.0837)], systolic [122 ± 19 vs. 124 ± 19 mm Hg (p = 0.4261)] and diastolic blood pressure [68 ± 13 vs. 70 ± 15 mm Hg (p = 0.3462)], and peripheral [98 (96-99) vs. 98 (95-99) % (p = 0.6353)] and venous oxygen saturation [71 ± 14 vs. 69 ± 14% (p = 0.1317)] did not change after the diagnostic protocol. Moreover, blood lactate [1.48 ± 0.65 vs. 1.53 ± 0.71 mmol/L (p = 0.2320)] did not change. CPK did not change up to 72 h after the test [99 (59-422) vs. 125 (66-674) (p = 0.2799) vs. 161 (66-352) (p > 0.999) vs. 100 (33-409) (p = 0.5901)]. The time taken to perform the diagnostic assessment was 11.3 ± 1.1 min. In addition, 75% of the patients presented very visible muscle contractions, and 25% of them presented barely visible muscle contractions.
CONCLUSIONS: The FES cycling-based muscular dysfunction diagnostic method is safe and feasible. Hemodynamic parameters, peripheral oxygen saturation, venous oxygen saturation, and blood lactate did not change after the diagnostic protocol. The muscle damage marker (CPK) did not increase up to 72 h after the diagnostic protocol.
METHODS: An observational prospective study was carried out with 20 critically ill, mechanically ventilated patients. The FES-cycling equipment was set in a specific diagnostic mode. For safety determination, hemodynamic parameters and peripheral oxygen saturation were measured before and immediately after the diagnostic protocol, as well as venous oxygen saturation and blood lactate. The creatine phosphokinase level (CPK) was measured before and 24, 48, and 72 h after the test. The time taken to carry out the entire diagnostic protocol and the number of patients with visible muscle contraction (capacity of perceptive muscular recruitment) were recorded to assess feasibility.
RESULTS: Heart rate [91 ± 23 vs. 94 ± 23 bpm (p = 0.0837)], systolic [122 ± 19 vs. 124 ± 19 mm Hg (p = 0.4261)] and diastolic blood pressure [68 ± 13 vs. 70 ± 15 mm Hg (p = 0.3462)], and peripheral [98 (96-99) vs. 98 (95-99) % (p = 0.6353)] and venous oxygen saturation [71 ± 14 vs. 69 ± 14% (p = 0.1317)] did not change after the diagnostic protocol. Moreover, blood lactate [1.48 ± 0.65 vs. 1.53 ± 0.71 mmol/L (p = 0.2320)] did not change. CPK did not change up to 72 h after the test [99 (59-422) vs. 125 (66-674) (p = 0.2799) vs. 161 (66-352) (p > 0.999) vs. 100 (33-409) (p = 0.5901)]. The time taken to perform the diagnostic assessment was 11.3 ± 1.1 min. In addition, 75% of the patients presented very visible muscle contractions, and 25% of them presented barely visible muscle contractions.
CONCLUSIONS: The FES cycling-based muscular dysfunction diagnostic method is safe and feasible. Hemodynamic parameters, peripheral oxygen saturation, venous oxygen saturation, and blood lactate did not change after the diagnostic protocol. The muscle damage marker (CPK) did not increase up to 72 h after the diagnostic protocol.
摘要：
背景：最近已经证明了一种基于FES-Cycling技术的非自愿诊断方法适用于机械通气患者。该方法对检测肌肉功能障碍和生存预后具有良好的敏感性和特异性。即使是无意识的病人。由于这种方法的临床相关性已经被报道，我们旨在评估其安全性和可行性。
方法：对20名危重病患者进行了一项观察性前瞻性研究，机械通气患者。将FES循环设备设置为特定的诊断模式。为了安全确定，在诊断方案之前和之后立即测量血液动力学参数和外周血氧饱和度,还有静脉血氧饱和度和血乳酸.在测试前和测试后24、48和72小时测量肌酸磷酸激酶水平（CPK）。记录执行整个诊断方案所花费的时间和具有可见肌肉收缩(感知肌肉募集的能力)的患者人数以评估可行性。
结果：心率[91±23vs.94±23bpm(p=0.0837)]，收缩压[122±19vs.124±19mmHg（p=0.4261）]和舒张压[68±13vs.70±15mmHg(p=0.3462)]，和外围[98（96-99）vs.98（95-99）％（p=0.6353）]和静脉血氧饱和度[71±14vs.69±14%(p=0.1317)]在诊断方案后没有变化。此外，血乳酸[1.48±0.65vs.1.53±0.71mmol/L（p=0.2320）]没有变化。CPK在试验后72小时内没有变化[99(59-422)与125（66-674）（p=0.2799）与161（66-352）（p>0.999）vs.100（33-409）（p=0.5901）]。进行诊断评估的时间为11.3±1.1分钟。此外,75%的患者表现出非常明显的肌肉收缩，25%的人表现出几乎看不见的肌肉收缩。
结论：基于FES循环的肌肉功能障碍诊断方法是安全可行的。血流动力学参数,外周血氧饱和度,静脉血氧饱和度,诊断方案后，血乳酸没有变化。诊断方案后72小时，肌肉损伤标记（CPK）没有增加。
方法：对20名危重病患者进行了一项观察性前瞻性研究，机械通气患者。将FES循环设备设置为特定的诊断模式。为了安全确定，在诊断方案之前和之后立即测量血液动力学参数和外周血氧饱和度,还有静脉血氧饱和度和血乳酸.在测试前和测试后24、48和72小时测量肌酸磷酸激酶水平（CPK）。记录执行整个诊断方案所花费的时间和具有可见肌肉收缩(感知肌肉募集的能力)的患者人数以评估可行性。
结果：心率[91±23vs.94±23bpm(p=0.0837)]，收缩压[122±19vs.124±19mmHg（p=0.4261）]和舒张压[68±13vs.70±15mmHg(p=0.3462)]，和外围[98（96-99）vs.98（95-99）％（p=0.6353）]和静脉血氧饱和度[71±14vs.69±14%(p=0.1317)]在诊断方案后没有变化。此外，血乳酸[1.48±0.65vs.1.53±0.71mmol/L（p=0.2320）]没有变化。CPK在试验后72小时内没有变化[99(59-422)与125（66-674）（p=0.2799）与161（66-352）（p>0.999）vs.100（33-409）（p=0.5901）]。进行诊断评估的时间为11.3±1.1分钟。此外,75%的患者表现出非常明显的肌肉收缩，25%的人表现出几乎看不见的肌肉收缩。
结论：基于FES循环的肌肉功能障碍诊断方法是安全可行的。血流动力学参数,外周血氧饱和度,静脉血氧饱和度,诊断方案后，血乳酸没有变化。诊断方案后72小时，肌肉损伤标记（CPK）没有增加。
