Neuromuscular Electrical Stimulation on Hemodynamic and Respiratory Response in Patients Submitted to Cardiac Surgery: Pilot Randomized Clinical Trial

Telma Cristina Fontes Cerqueira,Manoel Luiz De Cerqueira Neto,Lucas De Assis Pereira Cacau,José Teles De Mendonça,Amaro Afrânio De Araújo Filho,Vitor Oliveira Carvalho,Walderi Monteiro Da Silva Júnior,Valter Joviniano De Santana Filho,Géssica Uruga Oliveira,Auristela Julia Guilhermino Carvalho

doi:10.5935/2359-4802.20190028

Abstract

Abstract Background: Neuromuscular electrical stimulation seems to be a promising option to intensify the rehabilitation and improve the exercise capacity of patients in the immediate postoperative period of cardiac surgery. Objective: This study aimed to evaluate the hemodynamic (heart rate, systolic blood pressure, diastolic blood pressure, and mean blood pressure) and respiratory (respiratory rate and oxygen saturation) responses to neuromuscular electrical stimulation in the immediate postoperative period in patients submitted to cardiac surgery and to verify its feasibility and safety. Methods: This is a pilot randomized controlled trial, wherein critical patients in the immediate postoperative period of cardiac surgery were randomly assigned to a control group, using sham neuromuscular electrical stimulation, or an experimental group, submitted to neuromuscular electrical stimulation sessions (FES), for 60 min, with a 50-Hz frequency, 200-µs pulse duration, time on: 3 s, and time off: 9 s. Data distribution was evaluated by the Shapiro-Wilk test. The analysis of variance was used and a p-value < 0.05 was considered significant. Results: Thirty patients were included in the study. The neuromuscular electrical stimulation was applied within the first 23.13 ± 5.24 h after cardiac surgery, and no changes were found regarding the hemodynamic and respiratory variables between the patients who underwent neuromuscular electrical stimulation, and those in the control group. Conclusions: In the present study, neuromuscular electrical stimulation did not promote changes in hemodynamic and respiratory responses of patients in the immediate postoperative period of cardiac surgery.

Highlights

Muscle proteolysis has been known to accelerate within 48 h after cardiovascular surgery,[2] when patients are under significant mobilization restrictions, and use of mechanical ventilation, vasoactive drugs, sedatives, and analgesics, and the presence of catheters, thoracic, and mediastinal drains
The rehabilitation of patients after cardiac surgery becomes a challenge in the intensive care unit (ICU).[1,2,3]
Patients admitted to the ICU within the first 48 h after coronary artery bypass grafting and/or valve replacement were eligible for the study

Summary

Introduction

Cardiac surgery is an effective option and a safe procedure that increase quality of life and survival in patients with heart failure, it is still a complex procedure with many possible complications.[1,2,3] Muscle proteolysis has been known to accelerate within 48 h after cardiovascular surgery,[2] when patients are under significant mobilization restrictions, and use of mechanical ventilation, vasoactive drugs, sedatives, and analgesics, and the presence of catheters, thoracic, and mediastinal drains. Neuromuscular electrical stimulation seems to be a promising option to intensify the rehabilitation and improve the exercise capacity of patients in the immediate postoperative period of cardiac surgery

Methods

Results

Conclusion