PDF(Pubmed)
Abstract：
Background/Objectives: The aim of this study was to investigate the feasibility and safety of neuromuscular electrical stimulation (NMES) in patients on extracorporeal membrane oxygenation (ECMO) and thoroughly assess any potential adverse events. Methods: We conducted a prospective observational study assessing safety and feasibility, including 16 ICU patients on ECMO support who were admitted to the cardiac surgery ICU from January 2022 to December 2023. The majority of patients were females (63%) on veno-arterial (VA)-ECMO (81%), while the main cause was cardiogenic shock (81%) compared to respiratory failure. Patients underwent a 45 min NMES session while on ECMO support that included a warm-up phase of 5 min, a main phase of 35 min, and a recovery phase of 5 min. NMES was implemented on vastus lateralis, vastus medialis, gastrocnemius, and peroneus longus muscles of both lower extremities. Two stimulators delivered biphasic, symmetric impulses of 75 Hz, with a 400 μsec pulse duration, 5 sec on (1.6 sec ramp up and 0.8 sec ramp down) and 21 sec off. The intensity levels aimed to cause visible contractions and be well tolerated. Primary outcomes of this study were feasibility and safety, evaluated by whether NMES sessions were successfully achieved, and by any adverse events and complications. Secondary outcomes included indices of rhabdomyolysis from biochemical blood tests 24 h after the application of NMES. Results: All patients successfully completed their NMES session, with no adverse events or complications. The majority of patients achieved type 4 and 5 qualities of muscle contraction. Conclusions: NMES is a safe and feasible exercise methodology for patients supported with ECMO.
摘要：
背景/目的：本研究的目的是探讨神经肌肉电刺激（NMES）在体外膜氧合（ECMO）患者中的可行性和安全性，并彻底评估任何潜在的不良事件。方法：我们进行了一项前瞻性观察性研究，评估安全性和可行性。包括2022年1月至2023年12月入住心脏外科ICU的16名接受ECMO支持的ICU患者。大多数患者是女性（63％）在静脉动脉（VA）-ECMO（81％），与呼吸衰竭相比，主要原因是心源性休克（81％）。患者在ECMO支持下进行了45分钟的NMES会话，其中包括5分钟的热身阶段，一个35分钟的主要阶段，和5分钟的恢复阶段。NMES是在横盘上实施的，中肌,腓肠肌,和双下肢的腓骨长肌。两个刺激器双相输送，75Hz的对称脉冲，具有400微秒的脉冲持续时间，5秒开启(1.6秒斜坡上升和0.8秒斜坡下降)和21秒关闭。强度水平旨在引起可见的收缩并具有良好的耐受性。这项研究的主要结果是可行性和安全性，通过NMES会议是否成功实现来评估，以及任何不良事件和并发症。次要结果包括应用NMES后24小时生化血液测试的横纹肌溶解指数。结果：所有患者均顺利完成NMES会话，无不良事件或并发症。大多数患者达到了4型和5型肌肉收缩质量。结论：NMES是ECMO支持的患者安全可行的运动方法。
