Effects of neuromuscular electrical stimulation in critically ill patients: A systematic review and meta-analysis of randomised controlled trials
We performed a systematic review and meta-analysis to examine the effect of neuromuscular electrical stimulation (NES) on prevention of critical care myopathy and its effect on various clinical outcomes in the intensive care unit (ICU). This study involved systematic review and meta-analysis of rand...
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| Veröffentlicht in: | Australian critical care 2020-03, Vol.33 (2), p.203-210 |
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| creator | Zayed, Y. Kheiri, B. Barbarawi, M. Chahine, A. Rashdan, L. Chintalapati, S. Bachuwa, G. Al-Sanouri, I. |
| description | We performed a systematic review and meta-analysis to examine the effect of neuromuscular electrical stimulation (NES) on prevention of critical care myopathy and its effect on various clinical outcomes in the intensive care unit (ICU).
This study involved systematic review and meta-analysis of randomised controlled trials (RCTs) comparing NES (applied to different muscle groups combined with usual care) and usual care (passive and active exercises along with early mobilisation and rehabilitation). Included studies enrolled adult patients managed in the ICU for medical or surgical diseases who were or were not mechanically ventilated. The primary outcome was global muscle strength measured by the Medical Research Council grading system. Secondary outcomes included ICU mortality, duration of mechanical ventilation (MV), and ICU length of stay. Risk ratio for dichotomous data and mean difference (MD) for continuous data with their corresponding 95% confidence interval (CI) were calculated.
A search in major electronic databases, including PubMed, Cochrane Library, and Embase, from inception to November 2018 was carried out.
Six RCTs were included, representing 718 patients. The mean age 60 ± 15.3 years, and 60.6% were male. There was no significant difference between NES and usual care on global muscle strength measured by Medical Research Council grading system (MD: 0.45; 95% CI: −2.89 to 3.80; p = 0.79), ICU mortality (risk ratio: 1.30; 95% CI: 0.95–1.78; p = 0.10), duration of MV (days) (MD: -2.07; 95% CI: −5.06 to 0.92; p = 0.18), or ICU length of stay (days) (MD: -3.06; 95% CI: -9.79 to 3.68; p = 0.37) in comparison with the usual therapy alone in critically ill patients.
NES combined with usual care was not associated with significant differences in global muscle strength, ICU mortality, duration of MV, or ICU length of stay in comparison with usual care alone in critically ill patients. Further RCTs are needed to determine patients with maximum benefit and to examine NES safety and efficacy. |
| doi_str_mv | 10.1016/j.aucc.2019.04.003 |
| format | Article |
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This study involved systematic review and meta-analysis of randomised controlled trials (RCTs) comparing NES (applied to different muscle groups combined with usual care) and usual care (passive and active exercises along with early mobilisation and rehabilitation). Included studies enrolled adult patients managed in the ICU for medical or surgical diseases who were or were not mechanically ventilated. The primary outcome was global muscle strength measured by the Medical Research Council grading system. Secondary outcomes included ICU mortality, duration of mechanical ventilation (MV), and ICU length of stay. Risk ratio for dichotomous data and mean difference (MD) for continuous data with their corresponding 95% confidence interval (CI) were calculated.
A search in major electronic databases, including PubMed, Cochrane Library, and Embase, from inception to November 2018 was carried out.
Six RCTs were included, representing 718 patients. The mean age 60 ± 15.3 years, and 60.6% were male. There was no significant difference between NES and usual care on global muscle strength measured by Medical Research Council grading system (MD: 0.45; 95% CI: −2.89 to 3.80; p = 0.79), ICU mortality (risk ratio: 1.30; 95% CI: 0.95–1.78; p = 0.10), duration of MV (days) (MD: -2.07; 95% CI: −5.06 to 0.92; p = 0.18), or ICU length of stay (days) (MD: -3.06; 95% CI: -9.79 to 3.68; p = 0.37) in comparison with the usual therapy alone in critically ill patients.
NES combined with usual care was not associated with significant differences in global muscle strength, ICU mortality, duration of MV, or ICU length of stay in comparison with usual care alone in critically ill patients. Further RCTs are needed to determine patients with maximum benefit and to examine NES safety and efficacy.</description><identifier>ISSN: 1036-7314</identifier><identifier>EISSN: 1878-1721</identifier><identifier>DOI: 10.1016/j.aucc.2019.04.003</identifier><identifier>PMID: 31160215</identifier><language>eng</language><publisher>Australia: Elsevier Ltd</publisher><subject>Adult ; Aged ; Critical Care ; critical care myopathy ; Critical Illness - mortality ; critically ill patients ; Electric Stimulation ; Female ; Humans ; ICU-acquired weakness ; Intensive Care Units ; Length of Stay ; Male ; Meta-analysis ; Middle Aged ; Muscle Weakness - prevention & control ; Neuromuscular electrical stimulation ; Nursing ; Randomized Controlled Trials as Topic</subject><ispartof>Australian critical care, 2020-03, Vol.33 (2), p.203-210</ispartof><rights>2019 Australian College of Critical Care Nurses Ltd</rights><rights>Copyright © 2019 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-50c98fdce5c45dff85c0a8d158e9eb0d31075bf9edc0c0cf21694bb5648b8ec3</citedby><cites>FETCH-LOGICAL-c356t-50c98fdce5c45dff85c0a8d158e9eb0d31075bf9edc0c0cf21694bb5648b8ec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.aucc.2019.04.003$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31160215$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zayed, Y.</creatorcontrib><creatorcontrib>Kheiri, B.</creatorcontrib><creatorcontrib>Barbarawi, M.</creatorcontrib><creatorcontrib>Chahine, A.</creatorcontrib><creatorcontrib>Rashdan, L.</creatorcontrib><creatorcontrib>Chintalapati, S.</creatorcontrib><creatorcontrib>Bachuwa, G.</creatorcontrib><creatorcontrib>Al-Sanouri, I.</creatorcontrib><title>Effects of neuromuscular electrical stimulation in critically ill patients: A systematic review and meta-analysis of randomised controlled trials</title><title>Australian critical care</title><addtitle>Aust Crit Care</addtitle><description>We performed a systematic review and meta-analysis to examine the effect of neuromuscular electrical stimulation (NES) on prevention of critical care myopathy and its effect on various clinical outcomes in the intensive care unit (ICU).
This study involved systematic review and meta-analysis of randomised controlled trials (RCTs) comparing NES (applied to different muscle groups combined with usual care) and usual care (passive and active exercises along with early mobilisation and rehabilitation). Included studies enrolled adult patients managed in the ICU for medical or surgical diseases who were or were not mechanically ventilated. The primary outcome was global muscle strength measured by the Medical Research Council grading system. Secondary outcomes included ICU mortality, duration of mechanical ventilation (MV), and ICU length of stay. Risk ratio for dichotomous data and mean difference (MD) for continuous data with their corresponding 95% confidence interval (CI) were calculated.
A search in major electronic databases, including PubMed, Cochrane Library, and Embase, from inception to November 2018 was carried out.
Six RCTs were included, representing 718 patients. The mean age 60 ± 15.3 years, and 60.6% were male. There was no significant difference between NES and usual care on global muscle strength measured by Medical Research Council grading system (MD: 0.45; 95% CI: −2.89 to 3.80; p = 0.79), ICU mortality (risk ratio: 1.30; 95% CI: 0.95–1.78; p = 0.10), duration of MV (days) (MD: -2.07; 95% CI: −5.06 to 0.92; p = 0.18), or ICU length of stay (days) (MD: -3.06; 95% CI: -9.79 to 3.68; p = 0.37) in comparison with the usual therapy alone in critically ill patients.
NES combined with usual care was not associated with significant differences in global muscle strength, ICU mortality, duration of MV, or ICU length of stay in comparison with usual care alone in critically ill patients. Further RCTs are needed to determine patients with maximum benefit and to examine NES safety and efficacy.</description><subject>Adult</subject><subject>Aged</subject><subject>Critical Care</subject><subject>critical care myopathy</subject><subject>Critical Illness - mortality</subject><subject>critically ill patients</subject><subject>Electric Stimulation</subject><subject>Female</subject><subject>Humans</subject><subject>ICU-acquired weakness</subject><subject>Intensive Care Units</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Muscle Weakness - prevention & control</subject><subject>Neuromuscular electrical stimulation</subject><subject>Nursing</subject><subject>Randomized Controlled Trials as Topic</subject><issn>1036-7314</issn><issn>1878-1721</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UcuO1DAQjBCIfcAPcEA-ckloJ3EmQVxWq4VFWonL3i2n3ZY8cuLBdkDzGfzx9jALR-RDt8rV1XZVVb2T0EiQw8d9YzbEpgU5NdA3AN2L6lKOu7GWu1a-5B66od51sr-ornLeA7RTP_Svq4tOygFaqS6r33fOEZYsohMrbSkuW8YtmCQoMJ48miBy8QtjxcdV-FVg8uWEh6PwIYgDX9Ba8idxI_IxF1oYQJHop6dfwqxWLFRMbVYTjtn_2ZQYjYvPZAXGtaQYAre8zYT8pnrluNDb53pdPX65e7y9rx--f_12e_NQY6eGUivAaXQWSWGvrHOjQjCjlWqkiWawnYSdmt1EFoGPa-Uw9fOshn6cR8Luuvpwlj2k-GOjXDS_BykEs1Lcsm7bTsHQQT8xtT1TMcWcEzl9SH4x6agl6FMSeq9PSehTEhp6zUnw0Ptn_W1eyP4b-Ws9Ez6fCcSfZKuSzsg-Ilmf2Hlto_-f_hMZ3Z63</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Zayed, Y.</creator><creator>Kheiri, B.</creator><creator>Barbarawi, M.</creator><creator>Chahine, A.</creator><creator>Rashdan, L.</creator><creator>Chintalapati, S.</creator><creator>Bachuwa, G.</creator><creator>Al-Sanouri, I.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202003</creationdate><title>Effects of neuromuscular electrical stimulation in critically ill patients: A systematic review and meta-analysis of randomised controlled trials</title><author>Zayed, Y. ; Kheiri, B. ; Barbarawi, M. ; Chahine, A. ; Rashdan, L. ; Chintalapati, S. ; Bachuwa, G. ; Al-Sanouri, I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-50c98fdce5c45dff85c0a8d158e9eb0d31075bf9edc0c0cf21694bb5648b8ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Critical Care</topic><topic>critical care myopathy</topic><topic>Critical Illness - mortality</topic><topic>critically ill patients</topic><topic>Electric Stimulation</topic><topic>Female</topic><topic>Humans</topic><topic>ICU-acquired weakness</topic><topic>Intensive Care Units</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Muscle Weakness - prevention & control</topic><topic>Neuromuscular electrical stimulation</topic><topic>Nursing</topic><topic>Randomized Controlled Trials as Topic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zayed, Y.</creatorcontrib><creatorcontrib>Kheiri, B.</creatorcontrib><creatorcontrib>Barbarawi, M.</creatorcontrib><creatorcontrib>Chahine, A.</creatorcontrib><creatorcontrib>Rashdan, L.</creatorcontrib><creatorcontrib>Chintalapati, S.</creatorcontrib><creatorcontrib>Bachuwa, G.</creatorcontrib><creatorcontrib>Al-Sanouri, I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Australian critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zayed, Y.</au><au>Kheiri, B.</au><au>Barbarawi, M.</au><au>Chahine, A.</au><au>Rashdan, L.</au><au>Chintalapati, S.</au><au>Bachuwa, G.</au><au>Al-Sanouri, I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of neuromuscular electrical stimulation in critically ill patients: A systematic review and meta-analysis of randomised controlled trials</atitle><jtitle>Australian critical care</jtitle><addtitle>Aust Crit Care</addtitle><date>2020-03</date><risdate>2020</risdate><volume>33</volume><issue>2</issue><spage>203</spage><epage>210</epage><pages>203-210</pages><issn>1036-7314</issn><eissn>1878-1721</eissn><abstract>We performed a systematic review and meta-analysis to examine the effect of neuromuscular electrical stimulation (NES) on prevention of critical care myopathy and its effect on various clinical outcomes in the intensive care unit (ICU).
This study involved systematic review and meta-analysis of randomised controlled trials (RCTs) comparing NES (applied to different muscle groups combined with usual care) and usual care (passive and active exercises along with early mobilisation and rehabilitation). Included studies enrolled adult patients managed in the ICU for medical or surgical diseases who were or were not mechanically ventilated. The primary outcome was global muscle strength measured by the Medical Research Council grading system. Secondary outcomes included ICU mortality, duration of mechanical ventilation (MV), and ICU length of stay. Risk ratio for dichotomous data and mean difference (MD) for continuous data with their corresponding 95% confidence interval (CI) were calculated.
A search in major electronic databases, including PubMed, Cochrane Library, and Embase, from inception to November 2018 was carried out.
Six RCTs were included, representing 718 patients. The mean age 60 ± 15.3 years, and 60.6% were male. There was no significant difference between NES and usual care on global muscle strength measured by Medical Research Council grading system (MD: 0.45; 95% CI: −2.89 to 3.80; p = 0.79), ICU mortality (risk ratio: 1.30; 95% CI: 0.95–1.78; p = 0.10), duration of MV (days) (MD: -2.07; 95% CI: −5.06 to 0.92; p = 0.18), or ICU length of stay (days) (MD: -3.06; 95% CI: -9.79 to 3.68; p = 0.37) in comparison with the usual therapy alone in critically ill patients.
NES combined with usual care was not associated with significant differences in global muscle strength, ICU mortality, duration of MV, or ICU length of stay in comparison with usual care alone in critically ill patients. Further RCTs are needed to determine patients with maximum benefit and to examine NES safety and efficacy.</abstract><cop>Australia</cop><pub>Elsevier Ltd</pub><pmid>31160215</pmid><doi>10.1016/j.aucc.2019.04.003</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 1036-7314 |
| ispartof | Australian critical care, 2020-03, Vol.33 (2), p.203-210 |
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| subjects | Adult Aged Critical Care critical care myopathy Critical Illness - mortality critically ill patients Electric Stimulation Female Humans ICU-acquired weakness Intensive Care Units Length of Stay Male Meta-analysis Middle Aged Muscle Weakness - prevention & control Neuromuscular electrical stimulation Nursing Randomized Controlled Trials as Topic |
| title | Effects of neuromuscular electrical stimulation in critically ill patients: A systematic review and meta-analysis of randomised controlled trials |
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