Introduction

Neuromuscular impairment (NMI) affects almost half of critically ill patients. The purpose was to investigate the role of neuromuscular electrical stimulation (NMES) to gain more insight into the nature of the NMI associated with ICU admission. To this aim, we analyzed the strength-duration (S-D) curves of the rectus femoris muscles of ICU patients compared to healthy volunteers.

Methods

S-D curves were recorded from 44 healthy volunteers and 29 ICU patients. Three electrophysiological parameters were used to classify the neuromuscular function, from grade 0 (normal function), to grade 3 (no evocable muscle contraction). ICU patients underwent electroneurographic peroneal nerve testing (PENT) to analyze NMI by electroneurography (ENG).

Results

Three patients were classified as Grade 0; nine as mild NMI (Grade 1), 13 as Grade 2, and four showed unexcitable muscles (Grade 3). Mean CMAP amplitudes were 6.1, 3.4, 2.9 and 0.81 mV from Grade 0 to Grade 3, respectively. CMAP was inversely correlated to NMI grade (−1.7 mV, R² = 0.946, p < 0.05).

Conclusions

The normative parameters of the S-D curves obtained by NMES in healthy volunteers allowed identification of NMI in ICU patients. NMES was an affordable tool to evaluate NMI in ICU patients, providing additional information to that obtained by ENG.

中文翻译：

---

对评估危重患者神经肌肉损伤的力量持续时间测试的重新评估

简介

神经肌肉损伤 (NMI) 影响几乎一半的危重患者。目的是研究神经肌肉电刺激 (NMES) 的作用，以更深入地了解与入住 ICU 相关的 NMI 的性质。为此，我们分析了 ICU 患者与健康志愿者相比，股直肌的力量-持续时间 (SD) 曲线。

方法

记录了 44 名健康志愿者和 29 名 ICU 患者的 SD 曲线。三个电生理参数用于对神经肌肉功能进行分类，从 0 级（正常功能）到 3 级（无可唤起的肌肉收缩）。ICU 患者接受了神经电图腓神经测试 (PENT) 以通过神经电图 (ENG) 分析 NMI。

结果

三名患者被归类为 0 级；9 人为轻度 NMI（1 级），13 人为 2 级，4 人表现为肌肉不可兴奋（3 级）。从 0 级到 3 级，平均 CMAP 幅度分别为 6.1、3.4、2.9 和 0.81 mV。CMAP 与 NMI 等级呈负相关（-1.7 mV，R ²  = 0.946，p < 0.05）。

结论

通过 NMES 在健康志愿者中获得的 SD 曲线的规范参数允许识别 ICU 患者中的 NMI。NMES 是一种评估 ICU 患者 NMI 的经济实惠的工具，为 ENG 获得的信息提供了额外的信息。