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Electrical muscle stimulation prevents critical illness polyneuromyopathy a randomized parallel intervention trial.doc

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Electrical muscle stimulation prevents critical illness polyneuromyopathy a randomized parallel intervention trial

Routsi et al. Critical Care 2010, 14:R74 /content/14/2/R74 RESEARCH Open Access Electrical muscle stimulation prevents critical Research illness polyneuromyopathy: a randomized parallel intervention trial Christina Routsi, Vasiliki Gerovasili, Ioannis Vasileiadis, Eleftherios Karatzanos, Theodore Pitsolis, Elli Tripodaki, Vasiliki Markaki, Dimitrios Zervakis and Serafim Nanas* Abstract Introduction: Critical illness polyneuromyopathy (CIPNM) is a common complication of critical illness presenting with muscle weakness and is associated with increased duration of mechanical ventilation and weaning period. No preventive tool and no specific treatment have been proposed so far for CIPNM. Electrical muscle stimulation (EMS) has been shown to be beneficial in patients with severe chronic heart failure and chronic obstructive pulmonary disease. Aim of our study was to assess the efficacy of EMS in preventing CIPNM in critically ill patients. Methods: One hundred and forty consecutive critically ill patients with an APACHE II score ≥ 13 were randomly assigned after stratification to the EMS group (n = 68) (age:61 ± 19 years) (APACHE II:18 ± 4 , SOFA:9 ± 3) or to the control group (n = 72) (age:58 ± 18 years) (APACHE II:18 ± 5, SOFA:9 ± 3). Patients of the EMS group received daily EMS sessions. CIPNM was diagnosed clinically with the medical research council (MRC) scale for muscle strength (maximum score 60, 4 8/60 cut off for diagnosis) by two unblinded independent investigators. Duration of weaning from mechanical ventilation and intensive care unit (ICU) stay were recorded. Results: Fifty two patients could be finally evaluated with MRC; 24 in the EMS group and 28 in the control group. CIPNM was diagnosed in 3 patients in the EMS group as compared to 11 patients in the control group (OR = 0.22; CI: 0.05 to 0.92, P = 0.04 ). The MRC score was significantly higher in patients of the EMS group as compared to the control group [58 (33 to 60) vs. 52