Early mobilization is beneficial for critically ill patients because it reduces muscle weakness acquired in intensive care units. The objective of this study was to assess the effect of functional electrical stimulation (FES) and passive cycle ergometry (PCE) on the nitrous stress and inflammatory cytometry in critically ill patients. This was a controlled, randomized, open clinical trial carried out in a 16-bed intensive care unit. The patients were randomized into four groups: Control group (n=10), did not undergo any therapeutic intervention during the study; PCE group (n=9), lower-limb PCE for 30 cycles/min for 20 min; FES group (n=9), electrical stimulation of quadriceps muscle for 20 min; and FES with PCE group (n=7), patients underwent PCE and FES, with their order determined randomly. The serum levels of nitric oxide, tumor necrosis factor alpha, interferon gamma, and interleukins 6 and 10 were analyzed before and after the intervention. There were no differences in clinical or demographic characteristics between the groups. The results revealed reduced nitric oxide concentrations one hour after using PCE (Po0.001) and FES (Po0.05), thereby indicating that these therapies may reduce cellular nitrosative stress when applied separately. Tumor necrosis factor alpha levels were reduced after the PCE intervention (P=0.049). PCE and FES reduced nitric oxide levels, demonstrating beneficial effects on the reduction of nitrosative stress. PCE was the only treatment that reduced the tumor necrosis factor alpha concentration.
Aims: To analyze oxidative cellular stress and monitor the evolution of hematological parameters before and after of neuromuscular electrical stimulation (NMES) in critically ill patients.
Methods:A controlled and randomized clinical trial, composed of a sample of 19 patients, admitted to the Agamenon Magalhães Hospital intensive care unit. The patients were divided into two groups: NMES group (n=9), patients that underwent only one NMES in the quadriceps muscle for 20 min, and the other, control group (n=10) that did undergo any therapeutic intervention.
Results:In relation to the demographic and clinical variables, the groups were homogeneous at the beginning of the study. For the nitric oxide (NO) analysis, we perceived a reduction, when comparing the before and after analyses, in NO in the stimulated cell (p=0.0188) and non-stimulated cell (p=0.0258) in the NMES group. Also in relation to NO, when comparing the two groups, we observed a significant reduction in the NMES group compared to the control one. For the hematological parameters we did not observe any difference when comparing before and after in the two groups studied.
Conclusion:We can conclude that the use of NMES causes a reduction in cellular NO levels, showing the beneficial effects in reducing oxidative stress. With relation to complete blood count, we observed that its application was not able to causes any alterations.Keywords: Nitric oxide; Reactive species of oxygen and nitrogen; Physiotherapy in intensive care and physical exercise
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