title: Safety and feasibility of a neuromuscular electrical stimulation chronaxie-based protocol in critical ill patients: A prospective observational study.
abstract: The aim of this study was to evaluate the safety and feasibility of a neuromuscular electrical stimulation (NMES) protocol based on neuromuscular excitability and applied in numerous muscle groups of critical ill patients.
  
  
  
  We performed a prospective observational study using an NMES applied daily and bilaterally into 5 muscle groups in lower limbs for 3 consecutive days. The characteristics of NMES were 90 contractions per muscle, pulse width equal to chronaxie, and a pulse frequency of 100 Hz. We assessed safety with central venous oxygen saturation, serum lactate, and creatine phosphokinase measurements. To evaluate feasibility, we recorded the time spent for the entire NMES protocol and the number of NMES sessions completed.
  
  
  
  Eleven male patients finished the study. There were no significant changes observed in creatine phosphokinase from baseline up to 96 hours: 470(±270) IU/L and 455(±240) IU/L (P>.99). Central venous oxygen saturation and serum lactate had the same pattern with no significant variations (P=.23 and P=.8, respectively). The time spent during the whole procedure and the number of complete NMES sessions performed were 107±24 minutes and 84 sessions (85%), respectively.
  
  
  
  We demonstrated that NMES chronaxie-based protocol is safe and feasible.
authors.affiliation: Physical Therapy Division, University Hospital of Brasília, University of Brasília, Brasília, Federal District, Brazil; Health Sciences and Technologies PhD Program, University of Brasilia, Federal District, Brazil. Electronic address: pauloeugenio.bsb@gmail.com.
authors.forename: Paulo Eugênio
authors.initials: PE
authors.lastname: Silva
authors.affiliation: Centre d'Expertise de la Performance G. Cometti, UFR STAPS, Université de Bourgogne-Franche-Comté, Dijon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Babault
authors.affiliation: Physical Therapy Division, Faculdade Santo Agostinho, Teresina, Brazil.
authors.forename: João Batista
authors.initials: JB
authors.lastname: Mazullo
authors.affiliation: Physical Therapy Division, Faculdade Santo Agostinho, Teresina, Brazil.
authors.forename: Tamires Pereira
authors.initials: TP
authors.lastname: de Oliveira
authors.affiliation: Physical Therapy Division, Faculdade Santo Agostinho, Teresina, Brazil.
authors.forename: Bárbara Letícia
authors.initials: BL
authors.lastname: Lemos
authors.affiliation: Physical Therapy Division, Federal University of Sergipe, The GrEAt Group (Grupo de Estudos de Atividade Fisica), Sergipe, Brazil.
authors.forename: Vitor Oliveira
authors.initials: VO
authors.lastname: Carvalho
authors.affiliation: Physical Therapy Division, University of Brasilia, Brasília, Brazil.
authors.forename: Joao Luiz Quagliotti
authors.initials: JLQ
authors.lastname: Durigan
mesh_terms: D018806:APACHE; D000328:Adult; D002907:Chronaxy; D003422:Critical Care; D016638:Critical Illness; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D009119:Muscle Contraction / Q000502:physiology*; D018482:Muscle, Skeletal / Q000098:blood supply*; D011446:Prospective Studies; D012449:Safety
chemical_list: D019344:Lactic Acid
keywords: Intensive care; Intensive care unit–acquired weakness; Muscle weakness; Neuromuscular stimulation; Rehabilitation