Discriminatory characteristics of responders and non-responders septic patients to neuromuscular electrical stimulation - A subanalysis of a randomized controlled double-blinded trial.

Abstract

Objective: To define the discriminatory characteristics of patients with sepsis or septic shock, as well as responders and non-responders to the NMES protocol.

Design: This was a sub-analysis of a randomized, controlled, double-blind clinical trial.

Setting: An intensive care unit (ICU) at a private hospital.

Participants: Fifteen adult patients diagnosed with sepsis or septic shock underwent NMES sessions, among whom eight were classified as the responder group (RG) and seven were classified as the non-responder group (NRG) Interventions: The NMES protocol was initiated at 24 hours after admission with daily sessions. Assessments were performed through ultrasound measurements of the quadriceps femoris muscle and physical function scales.

Results: The rectus femoris thickness was maintained for RG from day 1 to day 4 and reduced by more than 10% for NRG. The Surgical ICU Optimal Mobilization Score (SOMS) statistically differed (p = 0.04) between the RG (2 points; IQI 0.25-3.5) and NRG (score 0) in the initial assessment. De Morton Mobility Index (DEMMI) in the RG increased from 19 ± 20 points to 33 ± 30 points at the final evaluation (p = 0.04), suggesting higher levels of mobility. There was a strong correlation between the initial SOMS (r = 0.72, p = 0.04), DEMMI (r = 0.77, p = 0.02), and muscle thickness in the RG. The NRG exhibited a strong negative correlation between the Sepsis-related Organ Failure Assessment (SOFA) score and rectus femoris thickness at baseline (r = -0.82, p = 0.04).

Conclusion: The SOMS and DEMMI could characterize responders to the NMES protocol, whereas the SOFA score did not correlate with responders.