Electric Muscle Stimulation for Weaning from Mechanical Ventilation in Elder Patients with Severe Sepsis and Acute Respiratory Failure – A Pilot Study

Shen, Sheng-Yeh; Lee, Chao-Hsien; Lin, Rong-Luh; Cheng, Kuang-Hua

doi:10.1016/j.ijge.2017.01.001

Cited by 7 publications

(12 citation statements)

References 28 publications

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“…Of 1,684 citations retrieved, we included two unique RCTs ( Fig 1 and Table 2 ) [ 15 , 29 ]. In total, 75 patients were represented across the two studies (44 interventions and 31 controls).…”

Section: Resultsmentioning

confidence: 99%

“…Data on QOL were available in 1 of the 2 trials [ 15 ], while data on ADL were not available in any of the trials. ICU mortality was reported in both trials [ 15 , 29 ]. Mean difference (95% CI) of physical function and physical role in QOL were 21.10 (6.57–35.63) and 44.40 (22.55–66.05), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…There was no significant differences in ICU length of stay and hospital length of stay between the intervention and control groups in both studies [ 15 , 29 ]. The data on muscle strength were available in 1 of 2 trials [ 15 ], and the mean difference (95% CI) of MRC sum-score was 4.60 (-2.69–11.89) and higher among those who received intervention.…”

Section: Resultsmentioning

confidence: 99%

“…Generalizability of rehabilitation for patients with sepsis in ICU may be poor. Only approximately 5% of patients screened were included [ 15 , 29 ] and there were also large differences between the number of participants recruited and the planned recruitment. The large difference between the number of participants recruited and those originally planned to be recruited was not only a potential feasibility issue in conducting trials in patients with sepsis but also the timing of the commencement of the intervention in which patients were managed by mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

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Rehabilitation for patients with sepsis: A systematic review and meta-analysis

Taito

Banno

et al. 2018

PLoS ONE

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The objective of this systematic review was to determine whether rehabilitation impacts clinically relevant outcomes among adult patients with sepsis. Randomized controlled trials from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PEDro, and the World Health Organization International Clinical Trials Platform Search Portal, as well as conference proceedings and reference lists of relevant articles were collected. Two reviewers independently identified randomized controlled trials on the rehabilitation of patients with sepsis, and the two reviewers independently abstracted trial level data including population characteristics, interventions, comparisons, and clinical outcomes. Our primary outcomes were quality of life (QOL), activity of daily living (ADL), and mortality. Our secondary outcomes were length of stay, return to work, muscle strength, delirium, and all adverse events. The quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We included two trials enrolling 75 patients. The mean difference (95% confidence interval [CI]) of physical function and physical role in QOL measured by SF-36 were 21.10 (95% CI: 6.57–35.63) and 44.40 (95% CI: 22.55–66.05), respectively. Rehabilitation did not significantly decrease intensive care unit (ICU) mortality (risk ratio, 2.02 [95% CI: 0.46–8.91], I2 = 0%; n = 75). ICU length of stay and hospital length of stay and muscle strength were not statistically significantly different and no adverse events were reported in both studies. The certainty of the evidence for these outcomes was “very low.” Data on ADL, return to work, and delirium were not available in any of the trials. Rehabilitation of patients with sepsis might not decrease ICU mortality, but might improve QOL. Further, well-designed trials measuring important outcomes will be needed to determine the benefit and harm of rehabilitation among patients with sepsis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Rehabilitation for patients with sepsis: A systematic review and meta-analysis

Taito

Banno

et al. 2018

PLoS ONE

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“…In evaluating the results of rehab in all conditions of post-intensive care syndrome, the outcomes of early rehabilitation are mixed but can be roughly divided into three categories: (1) no improvements in long or short-term physical outcomes (RCTs [ 56 , 57 , 58 , 59 , 60 ], reviews: [ 50 , 52 ]); (2) only short-term improvements, e.g., at the time of discharge, (RCTs: [ 43 , 61 , 62 ], reviews: [ 45 , 46 , 47 , 48 , 49 , 53 , 54 , 63 ]) and (3) long-term improvements (3–6 months), with or without short-term positive outcomes (3–6 months), (RCTs: [ 64 , 65 ], review: [ 44 ]).…”

Section: Skeletal Muscle Rehabilitation In Sepsis (In-hospital and Post-discharge)mentioning

confidence: 99%

Pathophysiology and Treatment Strategies of Acute Myopathy and Muscle Wasting after Sepsis

Mankowski

Laitano

Clanton

et al. 2021

JCM

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Sepsis survivors experience a persistent myopathy characterized by skeletal muscle weakness, atrophy, and an inability to repair/regenerate damaged or dysfunctional myofibers. The origins and mechanisms of this persistent sepsis-induced myopathy are likely complex and multifactorial. Nevertheless, the pathobiology is thought to be triggered by the interaction between circulating pathogens and impaired muscle metabolic status. In addition, while in the hospital, septic patients often experience prolonged periods of physical inactivity due to bed rest, which may exacerbate the myopathy. Physical rehabilitation emerges as a potential tool to prevent the decline in physical function in septic patients. Currently, there is no consensus regarding effective rehabilitation strategies for sepsis-induced myopathy. The optimal timing to initiate the rehabilitation intervention currently lacks consensus as well. In this review, we summarize the evidence on the fundamental pathobiological mechanisms of sepsis-induced myopathy and discuss the recent evidence on in-hospital and post-discharge rehabilitation as well as other potential interventions that may prevent physical disability and death of sepsis survivors.

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