title: Short-term systemic effect of electrical muscle stimulation in critically ill patients.
abstract: BACKGROUND
  Our study assessed the short-term effect of electrical muscle stimulation (EMS) of the lower extremities on the thenar muscle microcirculation of patients who are critically ill.
  
  
  METHODS
  Twenty-nine hospital ICU patients (19 men; mean [+/- SD] age, 58 +/- 19 years; mean acute physiology and chronic health evaluation score, 17 +/- 5; mean sequential organ failure assessment score, 9 +/- 3) underwent a 45-min session of EMS of the lower extremities. BP and heart rate were measured, and blood samples were retrieved. Tissue oxygen saturation (Sto(2)) was assessed with near infrared spectroscopy at the thenar muscle with a vascular occlusion before and after EMS. A control group of six patients who were critically ill (4 men; mean age, 50 +/- 19 years) also were included in the study.
  
  
  RESULTS
  The mean Sto(2) did not differ significantly before and after the EMS session (81 +/- 16% vs 83 +/- 16%, respectively). The oxygen consumption rate during vascular occlusion differed significantly before the beginning and at the end of the session (20 +/- 9%/min vs 22 +/- 9%/min, respectively; p < 0.05). The reperfusion rate differed significantly before the beginning and at the end of the session (299 +/- 177%/min vs 375 +/- 182%/min, respectively; p < 0.05). Heart rate increased significantly at the end of the session (94 +/- 16 beats/min vs 99 +/- 16 beats/min, respectively; p < 0.05) as did systolic BP (127 +/- 21 mm Hg vs 133 +/- 23 mm Hg; p < 0.05, respectively). The Sto(2) value did not differ between the two measurements in control patients.
  
  
  CONCLUSIONS
  The data suggest that EMS has a systemic effect on microcirculation. These results suggest that further studies are needed to explore the potential use of EMS as a preventive and rehabilitation tool in critically ill patients.
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Gerovasili
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Elli
authors.initials: E
authors.lastname: Tripodaki
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Karatzanos
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Theodore
authors.initials: T
authors.lastname: Pitsolis
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Markaki
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Zervakis
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Routsi
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Charis
authors.initials: C
authors.lastname: Roussos
authors.affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: snanas@cc.uoa.gr.
authors.forename: Serafim
authors.initials: S
authors.lastname: Nanas
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D016638:Critical Illness / Q000628:therapy*; D004558:Electric Stimulation; D005260:Female; D006339:Heart Rate; D006801:Humans; D007866:Leg; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply; D010101:Oxygen Consumption; D018579:Patient Selection