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Review ArticleSystematic Review

Effect of Neuromuscular Electrical Stimulation on the Duration of Mechanical Ventilation

Ruvistay E Gutiérrez-Arias, Constanza C Zapata-Quiroz, Benjamín O Prenafeta-Pedemonte, Nicolás A Nasar-Lillo and Diego I Gallardo-Zamorano
Respiratory Care January 2021, respcare.08363; DOI: https://doi.org/10.4187/respcare.08363
Ruvistay E Gutiérrez-Arias
Critical Care Unit, Instituto Nacional del Tórax, Santiago, Chile.
Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello, Santiago, Chile.
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  • For correspondence: [email protected]
Constanza C Zapata-Quiroz
Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello, Santiago, Chile.
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Benjamín O Prenafeta-Pedemonte
Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello, Santiago, Chile.
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Nicolás A Nasar-Lillo
Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello, Santiago, Chile.
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Diego I Gallardo-Zamorano
Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello, Santiago, Chile.
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Abstract

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.

  • neuromuscular electrical stimulation
  • electric stimulation therapy
  • artificial respiration
  • invasive mechanical ventilation
  • duration of mechanical ventilation
  • critical illness

Footnotes

  • Correspondence: Ruvistay E Gutiérrez-Arias PT MSc, Critical Care Unit, Instituto Nacional del Tórax, José Manuel Infante 717, Providencia, Santiago, Chile. E-mail: rgutierrez{at}torax.cl
  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • The authors have disclosed no conflicts of interest.

  • Copyright © 2021 by Daedalus Enterprises

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Respiratory Care: 66 (1)
Respiratory Care
Vol. 66, Issue 1
1 Jan 2021
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Effect of Neuromuscular Electrical Stimulation on the Duration of Mechanical Ventilation
Ruvistay E Gutiérrez-Arias, Constanza C Zapata-Quiroz, Benjamín O Prenafeta-Pedemonte, Nicolás A Nasar-Lillo, Diego I Gallardo-Zamorano
Respiratory Care Jan 2021, respcare.08363; DOI: 10.4187/respcare.08363

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Effect of Neuromuscular Electrical Stimulation on the Duration of Mechanical Ventilation
Ruvistay E Gutiérrez-Arias, Constanza C Zapata-Quiroz, Benjamín O Prenafeta-Pedemonte, Nicolás A Nasar-Lillo, Diego I Gallardo-Zamorano
Respiratory Care Jan 2021, respcare.08363; DOI: 10.4187/respcare.08363
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Keywords

  • neuromuscular electrical stimulation
  • electric stimulation therapy
  • artificial respiration
  • invasive mechanical ventilation
  • duration of mechanical ventilation
  • critical illness

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