Journal
INTERNATIONAL JOURNAL OF NURSING SCIENCES
Volume 7, Issue 2, Pages 228-237Publisher
ELSEVIER
DOI: 10.1016/j.ijnss.2020.03.002
Keywords
Activities of daily living; Electrical stimulation; Intensive care unit; Length of stay; Mechanical ventilation; Muscle strengths; Quality of life; Weakness
Categories
Funding
- Chinese Nursing Association research program [ZHKY201611]
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Objective: The early use of neuromuscular electrical stimulation (NMES) to prevent intensive care unitacquired weakness (ICU-AW) in critical patients is still a controversial topic. We conducted a systematic review to clarify the effectiveness of NMES in preventing ICU-AW. Methods: The Cochrane Library, PubMed, EMBASE, MEDLINE, Web of Science, Ovid, CNKI, Wanfang, VIP, China Biology Medicine disc (CBMdisc) and other databases were searched for randomized controlled trials on the influence of NMES on ICU-AW. The studies were selected according to the inclusion and exclusion criteria. After data and quality were evaluated, a meta-analysis was performed by RevMan 5.3 software. Results: A total of 11 randomized controlled trials with 576 patients were included. The meta-analysis results showed that NMES can improve muscle strength [MD = 1.78, 95% CI (0.44, 3.12, P = 0.009); shorten the mechanical ventilation (MV) time [SMD = -0.65, 95% CI (-1.03, -0.27, P = 0.001], ICU length of stay [MD = -3.41, 95% CI (-4.58, -4.24), P < 0.001], and total length of stay [MD = -3.97, 95% CI (-6.89, -1.06, P = 0.008]; improve the ability of patients to perform activities of daily living [SMD = 0.9, 95% CI (0.45, 1.35), P = 0.001]; and increase walking distance [MD = 239.03, 95% CI (179.22298.85), P < 0.001]. However, there is no evidence indicating that NMES can improve the functional status of ICU patients during hospitalization, promote the early awakening of patients or reduce mortality (P > 0.05). Conclusion: Early implementation of the NMES intervention in ICU patients can prevent ICU-AW and improve their quality of life by enhancing their muscle strength and shortening the MV duration, length of stay in the ICU and total length of stay in the hospital. (c) 2020 Chinese Nursing Association. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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