Research

Electrical muscle stimulation preserves the muscle mass of critically ill patients: a randomized study

Vasiliki Gerovasili¹ , Konstantinos Stefanidis¹ , Konstantinos Vitzilaios¹ , Eleftherios Karatzanos¹ , Panagiotis Politis¹ , Apostolos Koroneos¹ , Aikaterini Chatzimichail² , Christina Routsi¹ , Charis Roussos¹ and Serafim Nanas¹

¹First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, 45-47 Ypsilantou Str., 106 75, Athens, Greece

²Second Department of Radiology, Attiko Hospital, National and Kapodistrian University of Athens, 1 Rimini Str.,12462, Athens, Greece

author email corresponding author email

Critical Care 2009, 13:R161doi:10.1186/cc8123

Published:	8 October 2009

See related commentary by Stevens et al., http://ccforum.com/content/13/6/1002

Abstract

Introduction

Critically ill patients are characterized by increased loss of muscle mass, partially attributed to sepsis and multiple organ failure, as well as immobilization. Recent studies have shown that electrical muscle stimulation (EMS) may be an alternative to active exercise in chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) patients with myopathy. The aim of our study was to investigate the EMS effects on muscle mass preservation of critically ill patients with the use of ultrasonography (US).

Methods

Forty-nine critically ill patients (age: 59 ± 21 years) with an APACHE II admission score ≥13 were randomly assigned after stratification upon admission to receive daily EMS sessions of both lower extremities (EMS-group) or to the control group (control group). Muscle mass was evaluated with US, by measuring the cross sectional diameter (CSD) of the vastus intermedius and the rectus femoris of the quadriceps muscle.

Results

Twenty-six patients were finally evaluated. Right rectus femoris and right vastus intermedius CSD decreased in both groups (EMS group: from 1.42 ± 0.48 to 1.31 ± 0.45 cm, P = 0.001 control group: from 1.59 ± 0.53 to 1.37 ± 0.5 cm, P = 0.002; EMS group: from 0.91 ± 0.39 to 0.81 ± 0.38 cm, P = 0.001 control group: from 1.40 ± 0.64 to 1.11 ± 0.56 cm, P = 0.004, respectively). However, the CSD of the right rectus femoris decreased significantly less in the EMS group (-0.11 ± 0.06 cm, -8 ± 3.9%) as compared to the control group (-0.21 ± 0.10 cm, -13.9 ± 6.4%; P < 0.05) and the CSD of the right vastus intermedius decreased significantly less in the EMS group (-0.10 ± 0.05 cm, -12.5 ± 7.4%) as compared to the control group (-0.29 ± 0.28 cm, -21.5 ± 15.3%; P < 0.05).

Conclusions

EMS is well tolerated and seems to preserve the muscle mass of critically ill patients. The potential use of EMS as a preventive and rehabilitation tool in ICU patients with polyneuromyopathy needs to be further investigated.

Trial Registration

clinicaltrials.gov: NCT00882830