Polyneuropathies, Septic Shock, Muscle Weakness
Conditions
Keywords
polyneuropathies, muscle weakness, sepsis, septic shock, electrical stimulation, intensive care unit
Brief summary
The aim of this study is to compare the effect of EMS and conventional physical therapy on strength and muscle mass and development in adult patients with severe sepsis and septic shock.
Detailed description
Septic patients are at high risk of developing intensive care unit acquired weakness (ICUAW). Electrical muscle stimulation (EMS) has become an alternative exercise for critical and non-cooperative patients.
Interventions
electrical muscle stimulation: The parameters used in biceps were: 35 Hz, 250 μs and in quadriceps were: 50 Hz, 400 μs. In both, biphasic wave was used, 45 minutes of total work, 5 seconds of contraction and 10 seconds of relaxation and the intensity was adjusted to present a visible contraction
PROCEDUREconventional physical therapy
conventional physical therapy according to the adaptation of the Start to move protocol of Gosselink et al
Sponsors
University of Chile
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Subjects admitted to the ICU of the HCUCH in the period between November 2016 to August 2017 and January to June 2018 * Diagnosis of severe sepsis or septic shock * More than 48 hours in VMI * With sedation and / or neuromuscular blockade * Autovalent prior to admission to the ICU
Exclusion criteria
* Subjects from other hospitals / clinics or units of the hospital * Multiple trauma * Previous neuromuscular pathology * Pacemaker users * Pregnant women * BMI\> 35 * Epilepsy * Those who have refused to sign informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| intensive care unit acquired weakness | at awakening of the subject, an average of 8 days | Medical research council sum score: Bilateral testing of 6 muscle groups (shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion). Ranges from 0 (total paralysis) to 60 (normal strength). Score under 48 points indicates intensive care unit acquired weakness |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| muscle mass | at ICU admission of the subjet, at 48 hours post admission and at awakening of the subject, an average of 8 days | ultrasonography |
| maximum inspiratory pressure | at awakening of the subject, an average of 8 days | maximum inspiratory pressure |
| days of mechanical ventilation | an average of 11 days | number of days wirh mechanical ventilation |
| muscle strength | at awakening of the subject, an average of 8 days | Medical research council sum score: Bilateral testing of 6 muscle groups (shoulder abduction, elbow flexion, wrist extension, hip flexion, knee extension, and ankle dorsiflexion). Ranges from 0 (total paralysis) to 60 (normal strength). |
| days of ICU stay | at ICU discharge, an average of 18 days | number of days in ICU |
| mortality at 28 days | at 28 days post ICU admission | mortality |
| gait ability at hospital discharge | at hospital discharge, an averange of 3 months | presence or not of gait ability |
| Number of Participants with weaning failure | 48 hours post extubation day | Number of Participants who presented reintubation |
Outcome results
None listed