Effect of Neuromuscular Electrical Stimulation on the Duration of Mechanical Ventilation

医学 机械通风 功能性电刺激 刺激 随机对照试验 通风(建筑) 慢性阻塞性肺病 安慰剂 麻醉 物理医学与康复 物理疗法 内科学 机械工程 替代医学 病理 工程类
作者
Ruvistay E Gutiérrez-Arias,Constanza C Zapata-Quiroz,Benjamín O Prenafeta-Pedemonte,Nicolás A Nasar-Lillo,Diego I Gallardo-Zamorano
出处
期刊:Respiratory Care [American Association for Respiratory Care]
卷期号:66 (4): 679-685 被引量:4
标识
DOI:10.4187/respcare.08363
摘要

BACKGROUND:

It has been proposed that neuromuscular or functional electrical stimulation may have effects on respiratory muscles through its systemic effects, similar to those produced by exercise training. However, its impact on the duration of invasive mechanical ventilation has not been adequately defined. We sought to evaluate the effect of neuromuscular or functional electrical stimulation on the duration of invasive mechanical ventilation in critically ill subjects.

METHODS:

We systematically searched 3 databases up to August 2019 (ie, CENTRAL, MEDLINE, and EMBASE) as well as other resources to identify randomized controlled trials (RCTs) that evaluated the effects of neuromuscular or functional electrical stimulation compared to usual care/rehabilitation or placebo of neuromuscular or functional electrical stimulation on the duration of invasive mechanical ventilation.

RESULTS:

After reviewing 1,200 single records, 12 RCTs (N = 530 subjects) fulfilled our eligibility criteria. Three studies included only subjects with COPD (n = 106 subjects), whereas the rest considered subjects with different diseases. The most frequently stimulated muscle group was the quadriceps. Neuromuscular or functional electrical stimulation may decrease the duration of invasive mechanical ventilation (mean difference = –2.68 d, 95% CI –4.35 to –1.02, I2 = 50%, P = .002; 10 RCTs; low quality of evidence), and we are uncertain whether this effect may be more pronounced in subjects with COPD (mean difference = –2.90 d, 95% CI –4.58 to –1.23, I2 = 9%, P < .001; 3 RCTs; very low quality of evidence).

CONCLUSIONS:

Neuromuscular or functional electrical stimulation may slightly reduce the duration of invasive mechanical ventilation; we are uncertain whether these results are found in subjects with COPD compared to subjects receiving usual care or placebo, and the quality of the body of evidence is low to very low. More RCTs are needed with a larger number of subjects, with more homogeneous diseases and basal conditions, and especially with a more adequate methodological design.
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