Early Neuromuscular Electrical Stimulation Preserves Muscle Size and Quality and Maintains Systemic Levels of Signaling Mediators of Muscle Growth and Inflammation in Patients with Traumatic Brain Injury: A Randomized Clinical Trial

Overview

Journal Crit Care Res Pract

Publisher Wiley

Specialty Critical Care

Date 2023 Aug 7

PMID 37547450

Authors

Luciana Vieira

Paulo Eugenio Silva

Priscilla Flavia de Melo

Vinicius Maldaner

Joao Q Durigan

Rita de Cassia Marqueti

Otavio Nobrega

Sunita Mathur

Chris Burtin

Fabricio Barin

Wilcelly Machado-Silva

Sergio Ramalho

Gaspar R Chiappa

Nadia Oliveira Gomes

Celso R F Carvalho

Graziella F B Cipriano

Gerson Cipriano

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the effects of an early neuromuscular electrical stimulation (NMES) protocol on muscle quality and size as well as signaling mediators of muscle growth and systemic inflammation in patients with traumatic brain injury (TBI).

Design: Two-arm, single-blinded, parallel-group, randomized, controlled trial with a blinded assessment. . Trauma intensive care unit at a university hospital. . Forty consecutive patients on mechanical ventilation (MV) secondary to TBI were prospectively recruited within the first 24 hours following admission. . The intervention group (NMES; = 20) received a daily session of NMES on the rectus femoris muscle for five consecutive days (55 min/each session). The control group ( = 20) received usual care. . Muscle echogenicity and thickness were evaluated by ultrasonography. A daily blood sample was collected to assess circulating levels of insulin-like growth factor I (IGF-I), inflammatory cytokines, and matrix metalloproteinases (MMP).

Results: Both groups were similar at baseline. A smaller change in muscle echogenicity and thickness (difference between Day 1 and Day 7) was found in the control group compared to the NMES group (29.9 ± 2.1 vs. 3.0 ± 1.2, < 0.001; -0.79 ± 0.12 vs. -0.01 ± 0.06, < 0.001, respectively). Circulating levels of IGF-I, pro-inflammatory cytokines (IFN-y), and MMP were similar between groups.

Conclusion: An early NMES protocol can preserve muscle size and quality and maintain systemic levels of signaling mediators of muscle growth and inflammation in patients with TBI. This trial is registered with https://www.ensaiosclinicos.gov.br under number RBR-2db.

Citing Articles

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