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

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.

摘要
背景：神经肌肉电刺激（neuromuscular electrical stimulation）似乎是强化心脏外科手术后即刻患者康复效果、提升其运动能力的极具潜力的方案。
目的：本研究旨在评估心脏外科手术后即刻患者接受神经肌肉电刺激时的血流动力学（心率、收缩压、舒张压及平均动脉压）与呼吸功能（呼吸频率、血氧饱和度）反应，并验证该疗法的可行性与安全性。
方法：本研究为一项先导性随机对照试验，将心脏外科手术后即刻的重症患者随机分为两组：对照组采用假神经肌肉电刺激，实验组接受时长60分钟的神经肌肉电刺激治疗（FES），刺激参数设置为：频率50Hz、脉冲宽度200μs、通电时间3秒、断电时间9秒。采用夏皮罗-威尔克（Shapiro-Wilk）检验评估数据分布，以方差分析进行统计分析，以p值<0.05为差异具有统计学意义。
结果：本研究共纳入30例患者。神经肌肉电刺激于心脏手术后23.13±5.24小时内实施，实验组与对照组患者的血流动力学及呼吸功能指标均未出现显著组间差异。
结论：本研究结果显示，神经肌肉电刺激未对心脏外科手术后即刻患者的血流动力学及呼吸功能反应产生影响。