Neuromuscular electrical stimulation prevents muscle wasting in critically ill comatose patients

Journal article


Dirks, Marlou L., Hansen, Dominique, van Assche, Aimé, Dendale, Paul and van Loon, Luc J. C. 2015. Neuromuscular electrical stimulation prevents muscle wasting in critically ill comatose patients. Clinical Science. 128 (6), pp. 357 - 365. https://doi.org/10.1042/CS20140447
AuthorsDirks, Marlou L., Hansen, Dominique, van Assche, Aimé, Dendale, Paul and van Loon, Luc J. C.
Abstract

Fully sedated patients, being treated in the intensive care unit (ICU), experience substantial skeletal muscle loss. Consequently, survival rate is reduced and full recovery after awakening is compromised. Neuromuscular electrical stimulation (NMES) represents an effective method to stimulate muscle protein synthesis and alleviate muscle disuse atrophy in healthy subjects. We investigated the efficacy of twice-daily NMES to alleviate muscle loss in six fully sedated ICU patients admitted for acute critical illness [n=3 males, n=3 females; age 63±6 y; APACHE II (Acute Physiology and Chronic Health Evaluation II) disease-severity-score: 29±2]. One leg was subjected to twice-daily NMES of the quadriceps muscle for a period of 7±1 day whereas the other leg acted as a non-stimulated control (CON). Directly before the first and on the morning after the final NMES session, quadriceps muscle biopsies were collected from both legs to assess muscle fibre-type-specific cross-sectional area (CSA). Furthermore, phosphorylation status of the key proteins involved in the regulation of muscle protein synthesis was assessed and mRNA expression of selected genes was measured. In the CON leg, type 1 and type 2 muscle–fibre-CSA decreased by 16±9% and 24±7% respectively (P < 0.05). No muscle atrophy was observed in the stimulated leg. NMES increased mammalian target of rapamycin (mTOR) phosphorylation by 19±5% when compared with baseline (P < 0.05), with no changes in the CON leg. Furthermore, mRNA expression of key genes involved in muscle protein breakdown either declined [forkhead box protein O1 (FOXO1); P < 0.05] or remained unchanged [muscle atrophy F-box (MAFBx) and muscle RING-finger protein-1 (MuRF1)], with no differences between the legs. In conclusion, NMES represents an effective and feasible interventional strategy to prevent skeletal muscle atrophy in critically ill comatose patients.

Keywordscritical illness; disuse atrophy; intensive care unit (ICU); muscle wasting; neuromuscular electrical stimulation (NMES); skeletal muscle
Year2015
JournalClinical Science
Journal citation128 (6), pp. 357 - 365
PublisherPortland Press Ltd.
ISSN0143-5221
Digital Object Identifier (DOI)https://doi.org/10.1042/CS20140447
Scopus EID2-s2.0-84924922581
Page range357 - 365
Research GroupMary MacKillop Institute for Health Research
Place of publicationUnited Kingdom
Permalink -

https://acuresearchbank.acu.edu.au/item/88z8x/neuromuscular-electrical-stimulation-prevents-muscle-wasting-in-critically-ill-comatose-patients

Restricted files

Publisher's version

  • 0
    total views
  • 0
    total downloads
  • 0
    views this month
  • 0
    downloads this month

Export as