Neuromuscular Electrical Stimulation in Patients With Severe COVID-19 Associated With Sepsis and Septic Shock

Author(s)

Righetti, Renato Fraga ; Grams, Samantha Torres ; Costa, Wesla Neves da Silva ; Saraiva, Leandro Teixeira ; Salles, Isabel Chateaubriand Diniz de ; Yamaguti, Wellington Pereira

• Document type: Journal article
• Source: FRONTIERS IN MEDICINE; v. 9, p. 9-pg., 2022-02-16.

Abstract

BackgroundNeuromuscular electrical stimulation (NMES) can be applied to critically ill patients. However, its results on muscle strength and functionality in patients with COVID-19 are unknown. ObjectiveEvaluate the effects of intervention with NMES on muscle mass and functionality of patients with severe COVID-19 associated with sepsis and septic shock. MethodsSeven patients with COVID-19 associated with sepsis or septic shock were selected, but only 5 patients completed all days of the intervention with NMES. The intervention was performed by a single physiotherapist on 7 consecutive days in a daily session of 40 min. The outcome measures were the femoris cross-sectional area; thickness of the anterior compartment of the quadriceps muscle; rectus femoris echogenicity; International Classification of Functioning, Disability, and Health (ICF)-muscle strength; PFIT-s, DEMMI, and the SOMS; feasibility, and safety. The patients were evaluated on days 1, 5, and 8. ResultsThe rectus femoris cross-sectional area decreased significantly from days 1 to 8, but showed maintenance of the thickness of the anterior compartment of the quadriceps muscle from days 1 to 8. The MRC score increased significantly from days 1 to 5 and kept this improvement until day 8. All patients showed an increase in the MRC score and reduction of the ICF-muscle strength, meaning improved muscle strength from days 1 to 8. The PFIT-s increased significantly from days 1 to 5 and improved until day 8 compared to day 5. DEMMI and SOMS score increased significantly on day 8 compared to days 1 and 5. ConclusionRehabilitation with NMES showed improvement in muscle strength and functionality of patients in this study with a potential protective effect on muscle mass loss in patients with critical COVID-19 associated with sepsis and septic shock. This study is the first report of the potential effects of neuromuscular electrical stimulation in patients with severe COVID-19 associated with sepsis and septic shock. (AU)

• FAPESP's process: 18/16832-9 - Effects of electrical stimulation on the prevention of muscle mass loss in patients with sepsis and septic shock: a randomized, controlled, double-blind clinical trial
• Grantee: Wellington Pereira dos Santos Yamaguti
• Support Opportunities: Regular Research Grants