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急性强化电肌肉刺激对需要有创机械通气的 COVID-19 患者的影响:一项观察性病例对照研究。

Effects of acute phase intensive electrical muscle stimulation in COVID-19 patients requiring invasive mechanical ventilation: an observational case-control study.

机构信息

Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan.

Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Sci Rep. 2024 Mar 4;14(1):5254. doi: 10.1038/s41598-024-55969-8.

DOI:10.1038/s41598-024-55969-8
PMID:38438485
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10912433/
Abstract

We investigated the effects of acute-phase intensive electrical muscle stimulation (EMS) on physical function in COVID-19 patients with respiratory failure requiring invasive mechanical ventilation (IMV) in the intensive care unit (ICU). Consecutive COVID-19 patients requiring IMV admitted to a university hospital ICU between January and April 2022 (EMS therapy group) or between March and September 2021 (age-matched historical control group) were included in this retrospective observational case-control study. EMS was applied to both upper and lower limb muscles for up to 2 weeks in the EMS therapy group. The study population consisted of 16 patients undergoing EMS therapy and 16 age-matched historical controls (median age, 71 years; 81.2% male). The mean period until initiation of EMS therapy after ICU admission was 3.2 ± 1.4 days. The EMS therapy group completed a mean of 6.2 ± 3.7 EMS sessions, and no adverse events occurred. There were no significant differences between the two groups in Medical Research Council sum score (51 vs. 53 points, respectively; P = 0.439) or ICU mobility scale at ICU discharge. Addition of upper and lower limb muscle EMS therapy to an early rehabilitation program did not result in improved physical function at ICU discharge in severe COVID-19 patients.

摘要

我们研究了急性强化电肌肉刺激(EMS)对需要在重症监护病房(ICU)接受有创机械通气(IMV)的 COVID-19 呼吸衰竭患者身体功能的影响。这项回顾性观察性病例对照研究纳入了 2022 年 1 月至 4 月(EMS 治疗组)或 2021 年 3 月至 9 月(年龄匹配的历史对照组)期间因需要 IMV 而入住一所大学医院 ICU 的连续 COVID-19 患者。EMS 治疗组接受了为期长达 2 周的上肢和下肢肌肉 EMS 治疗。研究人群包括 16 名接受 EMS 治疗的患者和 16 名年龄匹配的历史对照组患者(中位年龄为 71 岁;81.2%为男性)。从 ICU 入院到开始 EMS 治疗的平均时间为 3.2±1.4 天。EMS 治疗组完成了 6.2±3.7 次 EMS 治疗,没有发生不良事件。两组间的医学研究理事会总分(分别为 51 分和 53 分;P=0.439)或 ICU 出院时的 ICU 移动量表评分均无显著差异。在重症 COVID-19 患者的早期康复方案中添加上肢和下肢肌肉 EMS 治疗并未导致 ICU 出院时身体功能的改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70a/10912433/5960e89369e6/41598_2024_55969_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70a/10912433/d17ee249eef1/41598_2024_55969_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70a/10912433/5960e89369e6/41598_2024_55969_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70a/10912433/d17ee249eef1/41598_2024_55969_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70a/10912433/5960e89369e6/41598_2024_55969_Fig2_HTML.jpg

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Guideline on multimodal rehabilitation for patients with post-intensive care syndrome.《重症监护后综合征患者的多模式康复指南》。
Crit Care. 2023 Jul 31;27(1):301. doi: 10.1186/s13054-023-04569-5.
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Effect of Neuromuscular Electrical Stimulation in Patients With Critical Illness: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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