Estimulación eléctrica neuromuscular en el paciente crítico. Una revisión narrativa
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Date
2022
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Abstract
Los avances en el tratamiento de pacientes críticamente enfermos han llevado a una mayor tasa de supervivencia. Sin embargo, los sobrevivientes a menudo experimentan consecuencias significativas asociadas al modelo convencional de atención, en el cual los pacientes tienden a permanecer inactivos, particularmente durante el tratamiento con ventilación mecánica (VM) y uso prolongado de sedación. Esto puede determinar trastornos mentales, psicológicos, del habla y deglución, y/o secuelas físicas, entre las que destacan la debilidad muscular y la consecuente discapacidad física, la que en muchos casos persisten tras el alta. La evidencia actual sugiere que la estimulación eléctrica neuromuscular tiene un efecto positivo sobre la masa y fuerza de los músculos estimulados, pudiendo además inducir efectos sistémicos pro-miogénicos, antiinflamatorios y regenerativos, que podrían influir en una disminución del tiempo de VM entre otros beneficios. Estos efectos podrían impactar desenlaces relevantes para los tomadores de decisiones, como la disminución de la estadía en unidades de cuidados intensivos y el tiempo de hospitalización total
Advances in the treatment of critically ill patients have led to increased survival rates. However, survivors often experience significant consequences associated with the conventional model of care, in which patients tend to remain inactive, particularly during treatment with mechanical ventilation (MV) and prolonged use of sedation. This can result in mental, psychological, speech and swallowing disorders, and/or physical sequelae, including muscle weakness and consequent physical disability, which in many cases persist after discharge. Current evidence suggests that neuromuscular electrical stimulation has a positive effect on the mass and strength of the stimulated muscles, and may also induce systemic pro-myogenic, anti-inflammatory and regenerative effects, which could influence a decrease in MV time among other benefits. These effects could impact outcomes relevant to decision-makers, such as reduced intensive care unit length of stay and total hospitalization time.
Advances in the treatment of critically ill patients have led to increased survival rates. However, survivors often experience significant consequences associated with the conventional model of care, in which patients tend to remain inactive, particularly during treatment with mechanical ventilation (MV) and prolonged use of sedation. This can result in mental, psychological, speech and swallowing disorders, and/or physical sequelae, including muscle weakness and consequent physical disability, which in many cases persist after discharge. Current evidence suggests that neuromuscular electrical stimulation has a positive effect on the mass and strength of the stimulated muscles, and may also induce systemic pro-myogenic, anti-inflammatory and regenerative effects, which could influence a decrease in MV time among other benefits. These effects could impact outcomes relevant to decision-makers, such as reduced intensive care unit length of stay and total hospitalization time.
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Keywords
Estimulación eléctrica, Unidades de cuidados intensivos, Debilidad muscular, Electric stimulation therapy, Intensive care units, muscle weakness., Muscle weakness