Safety of neuromuscular electrical stimulation among critically ill patients: systematic review

Abstract

ObjectiveTo review the evidence on the safety of neuromuscular electrical stimulation when used in the intensive care unit.MethodsA systematic review was conducted; a literature search was performed of the MEDLINE (via PubMed), PEDro, Cochrane CENTRAL and EMBASE databases, and a further manual search was performed among the references cited in randomized studies. Randomized clinical trials that compared neuromuscular electrical stimulation to a control or placebo group in the intensive care unit and reporting on the technique safety in the outcomes were included. Hemodynamic variables and information on adverse effects were considered safety parameters. Articles were independently analyzed by two reviewers, and the data analysis was descriptive.ResultsThe initial search located 1,533 articles, from which only four randomized clinical trials were included. Two studies assessed safety based on hemodynamic variables, and only one study reported an increase in heart rate, respiratory rate and blood lactate, without clinical relevance. The other two studies assessed safety based on reported adverse effects. In one, 15% of patients described a prickling sensation, without any clinically relevant abnormalities. In the other, one patient suffered a superficial burn due to improper parameter configuration.ConclusionNeuromuscular electrical stimulation is safe for critically ill patients; however, it should be applied by duly trained professionals and with proper evidence-based parameters.

Is transcutaneous electrical muscle stimulation an alternative for preventing acquired muscle weakness in the pediatric intensive care unit? A scoping review

“…Of four studies analyzed, only one reported an increase in heart rate, respiratory rate, and blood lactate, without any clinically relevant abnormalities. 26 Of note, no adverse effects were found in patients based on RCTs in this present review, even when TEMS was used for 8 hours. 21 With these findings, it is possible to hint that TEMS is safe provided it is properly applied by a duly trained professional in the PICU.…”

“…In the early phase of stay in the PICU, they are susceptible to develop PICAW, mainly the most critical, who are unable to carry out active mobilization . In this sense, TEMS has shown to be feasible and safe with positive outcomes in adults ICU patients …”

“…3 In this sense, TEMS has shown to be feasible and safe with positive outcomes in adults ICU patients. 26 Segers et al 27 showed that in critically ill adults, performing TEMS on quadriceps, during 25 minutes, 5 days a week, there was no significant change in clinical parameters (heart rate, blood pressure, respiratory rate, and peripheral oxygen saturation) or adverse cutaneous reactions (redness and local edema). The authors concluded that TEMS is a safe and effective intervention to be used in the ICU.…”

The use of the electrical stimulation device for the muscles in the limit determines the elbow joint during the lifting of the disabled weightlifting players

“…The proposed and available EMS devices are providing with more electrodes to examine two hands at a time and compare the strength of the muscles of two hands. This operation can give proven results and revival from the elbow joint injuries while doing the practice of weightlifting (Sachetti et al, 2018).…”

Segurança na aplicação da eletroestimulação neuromuscular no doente crítico: estudo piloto

“…Portanto, a partir da observação dos efeitos positivos da NMES é importante comprovar a segurança de sua aplicação em pacientes críticos. 5,11,13,14 .…”