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Original Research: CRITICAL CARE MEDICINE |

Short-term Systemic Effect of Electrical Muscle Stimulation in Critically Ill Patients

Vasiliki Gerovasili, MD; Elli Tripodaki, MD; Eleftherios Karatzanos, MSc; Theodore Pitsolis, MD; Vasiliki Markaki, MD; Dimitrios Zervakis, MD; Christina Routsi, MD; Charis Roussos, MD, PhD, FCCP; Serafim Nanas, MD
Author and Funding Information

Affiliations: From the First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Correspondence to: Serafim Nanas, MD, First Critical Care Department, National and Kapodistrian University of Athens, Evangelismos Hospital, Ypsilantou 45-47, 106 75, Athens, Greece; e-mail: snanas@cc.uoa.gr


Funding/Support: This research project (PENED) was cofinanced by the EU-European Social Fund and the Greek Ministry of Development (GSRT).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(5):1249-1256. doi:10.1378/chest.08-2888
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Background:  Our study assessed the short-term effect of electrical muscle stimulation (EMS) of the lower extremities on the thenar muscle microcirculation of patients who are critically ill.

Methods:  Twenty-nine hospital ICU patients (19 men; mean [± SD] age, 58 ± 19 years; mean acute physiology and chronic health evaluation score, 17 ± 5; mean sequential organ failure assessment score, 9 ± 3) underwent a 45-min session of EMS of the lower extremities. BP and heart rate were measured, and blood samples were retrieved. Tissue oxygen saturation (Sto2) was assessed with near infrared spectroscopy at the thenar muscle with a vascular occlusion before and after EMS. A control group of six patients who were critically ill (4 men; mean age, 50 ± 19 years) also were included in the study.

Results:  The mean Sto2 did not differ significantly before and after the EMS session (81 ± 16% vs 83 ± 16%, respectively). The oxygen consumption rate during vascular occlusion differed significantly before the beginning and at the end of the session (20 ± 9%/min vs 22 ± 9%/min, respectively; p < 0.05). The reperfusion rate differed significantly before the beginning and at the end of the session (299 ± 177%/min vs 375 ± 182%/min, respectively; p < 0.05). Heart rate increased significantly at the end of the session (94 ± 16 beats/min vs 99 ± 16 beats/min, respectively; p < 0.05) as did systolic BP (127 ± 21 mm Hg vs 133 ± 23 mm Hg; p < 0.05, respectively). The Sto2 value did not differ between the two measurements in control patients.

Conclusion:  The data suggest that EMS has a systemic effect on microcirculation. These results suggest that further studies are needed to explore the potential use of EMS as a preventive and rehabilitation tool in critically ill patients.

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