Neuromuscular Electrical Stimulation on Hemodynamic and Respiratory Response in Patients Submitted to Cardiac Surgery: Pilot Randomized Clinical Trial

Abstract

Background: Neuromuscular electrical stimulation seems to be a promising option to intensify the rehabilitation and improve the exercise capacity of patients in the immediate postoperative period of cardiac surgery.Objective: This study aimed to evaluate the hemodynamic (heart rate, systolic blood pressure, diastolic blood pressure, and mean blood pressure) and respiratory (respiratory rate and oxygen saturation) responses to neuromuscular electrical stimulation in the immediate postoperative period in patients submitted to cardiac surgery and to verify its feasibility and safety.Methods: This is a pilot randomized controlled trial, wherein critical patients in the immediate postoperative period of cardiac surgery were randomly assigned to a control group, using sham neuromuscular electrical stimulation, or an experimental group, submitted to neuromuscular electrical stimulation sessions (FES), for 60 min, with a 50-Hz frequency, 200-μs pulse duration, time on: 3 s, and time off: 9 s. Data distribution was evaluated by the Shapiro-Wilk test. The analysis of variance was used and a p-value < 0.05 was considered significant.Results: Thirty patients were included in the study. The neuromuscular electrical stimulation was applied within the first 23.13 ± 5.24 h after cardiac surgery, and no changes were found regarding the hemodynamic and respiratory variables between the patients who underwent neuromuscular electrical stimulation, and those in the control group. Conclusions:In the present study, neuromuscular electrical stimulation did not promote changes in hemodynamic and respiratory responses of patients in the immediate postoperative period of cardiac surgery.

Neuromuscular Electrical Stimulation: A Promising Modality of Exercise Training in Cardiovascular Rehabilitation Phase I?

“…This study evaluated the effects of NMES on systolic blood pressure, diastolic blood pressure and heart rate (HR) and peripheral oxygen saturation, which can be considered as independent predictive variables with a negative impact on adverse events in the immediate postoperative period of cardiac surgery. 2 The authors in this study demonstrated that in the first 23.13 ± 5.24 hours after cardiac surgery there were no abnormalities in hemodynamic and respiratory parameters between patients who underwent NMES and their respective control group. 2 By investigating the feasibility and safety of the use of this technique in patients, Cerqueira et al 2 reported that, in their sample, NMES did not determine significant abnormal findings that could result in risk to patients in the immediate postoperative period.…”

“…2 The authors in this study demonstrated that in the first 23.13 ± 5.24 hours after cardiac surgery there were no abnormalities in hemodynamic and respiratory parameters between patients who underwent NMES and their respective control group. 2 By investigating the feasibility and safety of the use of this technique in patients, Cerqueira et al 2 reported that, in their sample, NMES did not determine significant abnormal findings that could result in risk to patients in the immediate postoperative period. 2…”

“…So, what would be the role of NMES in heart surgery? Cerqueira et al, 2 used NMES in patients undergoing cardiac surgery in the immediate postoperative period. This study evaluated the effects of NMES on systolic blood pressure, diastolic blood pressure and heart rate (HR) and peripheral oxygen saturation, which can be considered as independent predictive variables with a negative impact on adverse events in the immediate postoperative period of cardiac surgery.…”

The effects of transcutaneous electrostimulation in patients in the intensive care unit

“…O objetivo deste estudo é avaliar os principais benefícios da eletroestimulação transcutânea em pacientes críticos em unidade de terapia intensiva, avaliando o aumento da força muscular, independência funcional, diminuição da hospitalização, ventilação mecânica e sedação. Dos sete estudos, apenas três não apresentaram melhora significativa na comparação entre os grupos controle e experimental 18 , observaram melhora na independência funcional nas atividades da vida diária, sem aumento da força muscular 19 . por outro lado, não observaram diferença significativa entre os grupos em relação à distância percorrida no TC6, a velocidade de caminhada, a força muscular, a independência funcional e a qualidade de vida são justificadas pela curta permanência dos pacientes no hospital 21 .…”

“…Em resumo, um total de sete artigos, quatro obtiveram resultados significativos no grupo experimental 15,17,20 . e três artigos não obtiveram melhorias equivalentes nos dois grupos 18,19,21 . Os estudos apresentaram importantes limitações quanto a utilizaram protocolos de eletroestimulação, diferentes grupos musculares, diferentes parâmetros da EENM, tempo de terapia e frequência de sessões, obtendo resultados diferentes.…”