Electrical Muscle Stimulation in the Development of Acquired Weakness in Patients With Severe Sepsis and Septic Shock

University of Chile23 enrolled

Overview

The aim of this study is to compare the effect of EMS and conventional physical therapy on strength and muscle mass and development in adult patients with severe sepsis and septic shock.

Septic patients are at high risk of developing intensive care unit acquired weakness (ICUAW). Electrical muscle stimulation (EMS) has become an alternative exercise for critical and non-cooperative patients.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

Polyneuropathies Septic Shock Muscle Weakness

Interventions

electrical muscle stimulationDEVICE

electrical muscle stimulation: The parameters used in biceps were: 35 Hz, 250 μs and in quadriceps were: 50 Hz, 400 μs. In both, biphasic wave was used, 45 minutes of total work, 5 seconds of contraction and 10 seconds of relaxation and the intensity was adjusted to present a visible contraction

conventional physical therapyPROCEDURE

conventional physical therapy according to the adaptation of the "Start to move" protocol of Gosselink et al

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Subjects admitted to the ICU of the HCUCH in the period between November 2016 to August 2017 and January to June 2018 * Diagnosis of severe sepsis or septic shock * More than 48 hours in VMI * With sedation and / or neuromuscular blockade * Autovalent prior to admission to the ICU Exclusion Criteria: * Subjects from other hospitals / clinics or units of the hospital * Multiple trauma * Previous neuromuscular pathology * Pacemaker users * Pregnant women * BMI\> 35 * Epilepsy * Those who have refused to sign informed consent

Outcomes

Primary Outcomes

intensive care unit acquired weakness

Medical research council sum score: Bilateral testing of 6 muscle groups (shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion). Ranges from 0 (total paralysis) to 60 (normal strength). Score under 48 points indicates intensive care unit acquired weakness

Time frame: at awakening of the subject, an average of 8 days

Secondary Outcomes

muscle strength

Time frame: at awakening of the subject, an average of 8 days

muscle mass

ultrasonography

Time frame: at ICU admission of the subjet, at 48 hours post admission and at awakening of the subject, an average of 8 days

maximum inspiratory pressure

Time frame: at awakening of the subject, an average of 8 days

days of mechanical ventilation

number of days wirh mechanical ventilation

Time frame: an average of 11 days

Number of Participants with weaning failure

Number of Participants who presented reintubation

Time frame: 48 hours post extubation day

days of ICU stay

number of days in ICU

Time frame: at ICU discharge, an average of 18 days

Data from ClinicalTrials.gov

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