Abstract
Early mobilization is beneficial for critically ill patients because it reduces muscle weakness acquired in intensive care units. The objective of this study was to assess the effect of functional electrical stimulation (FES) and passive cycle ergometry (PCE) on the nitrous stress and inflammatory cytometry in critically ill patients. This was a controlled, randomized, open clinical trial carried out in a 16-bed intensive care unit. The patients were randomized into four groups: Control group (n=10), did not undergo any therapeutic intervention during the study; PCE group (n=9), lower-limb PCE for 30 cycles/min for 20 min; FES group (n=9), electrical stimulation of quadriceps muscle for 20 min; and FES with PCE group (n=7), patients underwent PCE and FES, with their order determined randomly. The serum levels of nitric oxide, tumor necrosis factor alpha, interferon gamma, and interleukins 6 and 10 were analyzed before and after the intervention. There were no differences in clinical or demographic characteristics between the groups. The results revealed reduced nitric oxide concentrations one hour after using PCE (P<0.001) and FES (P<0.05), thereby indicating that these therapies may reduce cellular nitrosative stress when applied separately. Tumor necrosis factor alpha levels were reduced after the PCE intervention (P=0.049). PCE and FES reduced nitric oxide levels, demonstrating beneficial effects on the reduction of nitrosative stress. PCE was the only treatment that reduced the tumor necrosis factor alpha concentration.
Highlights
Mobilization is beneficial for critically ill patients because it reduces muscle weakness acquired in intensive care units (ICU)
This is the first study to compare the effects of different types of exercise on nitrosative stress and inflammatory cytokines in critically ill patients
This study demonstrated that both passive cycle ergometry (PCE) and functional electrical stimulation (FES) reduced nitrosative stress, as shown by the reduction in cellular nitric oxide (NO) levels
Summary
Mobilization is beneficial for critically ill patients because it reduces muscle weakness acquired in intensive care units (ICU). Mechanical ventilation and immobility are the main risk factors for developing muscle alterations, and knowledge regarding these risks and their identification are very important [1]. This dysfunction is associated with inflammatory deregulation that apparently contributes to the onset of myopathy. Important results regarding the rehabilitation of critically ill patients have been published in the literature, showing the benefit of increasing the practice of rehabilitation exercises, which aim to reduce symptoms and improve function regardless of disease stage [4].
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