Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2024; 16(10): 604-607
Published online Oct 26, 2024. doi: 10.4330/wjc.v16.i10.604
Evaluating neuromuscular electrical stimulation for preventing and managing intensive care unit-acquired weakness: Current evidence and future directions
Annu Lisa Kurian, Brandon Lucke-Wold
Annu Lisa Kurian, College of Medicine, Florida State University, Tallahassee, FL 32304, United States
Brandon Lucke-Wold, Department of Neurosurgery, University of Florida, Gainesville, FL 32611, United States
Author contributions: Kurian AL collaborated with the other author in conceptualization of the paper; She designed the structure of the paper, crafted the first draft, and was the primary editor; Lucke-Wold B also contributed to the conceptualization, assisted in organizing the project, provided senior oversight, and conducted quality review of the paper; He is also the co-corresponding author.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Brandon Lucke-Wold, MD, PhD, Doctor, Neurosurgeon, Research Scientist, Department of Neurosurgery, University of Florida, 1505 SW Archer Road, Gainesville, FL 32611, United States. brandon.lucke-wold@neurosurgery.ufl.edu
Received: April 19, 2024
Revised: September 3, 2024
Accepted: September 20, 2024
Published online: October 26, 2024
Processing time: 180 Days and 16.1 Hours
Abstract

Intensive care unit-acquired weakness (ICU-AW) is a prevalent issue in critical care, leading to significant muscle atrophy and functional impairment. Aiming to address this, Neuromuscular Electrical Stimulation (NMES) has been explored as a therapy. This systematic review assesses NMES's safety and effectiveness in enhancing functional capacity and mobility in pre- and post-cardiac surgery patients. NMES was generally safe and feasible, with intervention sessions varying in frequency and duration. Improvements in muscle strength and 6-minute walking test distances were observed, particularly in preoperative settings, but postoperative benefits were inconsistent. NMES showed promise in preventing muscle loss and improving strength, although its impact on overall functional capacity remained uncertain. Challenges such as short ICU stays and body composition affecting NMES efficacy were noted. NMES also holds potential for other conditions like cerebral palsy and stroke. Further research is needed to optimize NMES protocols and better understand its full benefits in preventing ICU-AW and improving patient outcomes.

Keywords: Neuromuscular electrical stimulation; Intensive care unit-acquired weakness; Cardiac surgery; Muscle atrophy; Functional capacity

Core Tip: Muscle weakness, termed intensive care unit-acquired weakness (ICU-AW), commonly affects limb and respiratory muscles, causing severe atrophy and functional impairment. Neuromuscular Electrical Stimulation (NMES) is a promising therapy that induces muscle contractions without patient effort. While NMES is safe and feasible, its effectiveness in improving post-surgery functional capacity is limited. It shows potential in preventing neuromyopathy and enhancing muscle strength, especially when used preoperatively. NMES may also benefit conditions beyond cardiac surgery, such as cerebral palsy and stroke. Further research is needed to fully understand and optimize NMES for preventing ICU-AW and improving outcomes in critical care settings.