Inflammation Clinical Trial
Official title:
Difference of Muscle Power and Myokine Profile After Upper Limb or Lower Limb Electric Muscle Stimulation in Patients With Severe Sepsis and Acute Respiratory Failure
Rationale : Electric muscle stimulation reduced critical-illness related weakness in patients
with severe sepsis and septic shock. But optimal protocol of the stimulation in unknown.
Hypothesis: Focal muscle contraction may improved the muscle power and have systemic
anti-inflammatory via cytokine secretion . The difference of electricity used in upper limb
or lower limb stimulation may lead to different effect.
Study design: Stratified randomized parallel control study, comparing Biceps, Quadriceps
electric muscle stimulation vs. non-stimulation group.
Participant: adult patients with severe sepsis and acute respiratory failure requiring
mechanical ventilation.
Intervention: daily stimulation of bilateral Biceps or Quadriceps by programmed electric
devices 32 minutes, 5 days/week
Outcome:
1. Primary outcome: Ventilator-dependent days
2. Secondary outcome: change of hand drip muscle
power/interleukin-1b/interleukin-6/interleukin-8/TNF-alpha
Background : Severe sepsis and septic shock remain top cause of admission to intensive care
unit. Muscle weakness was found in 70-100% patients with severe sepsis and septic shock
because of critical-illness induced polyneuropathy and myopathy. Previous study revealed
electric muscle stimulation (EMS) could reduce such muscle weakness and mechanical
ventilator-dependent days.
Hypothesis: different electricity may be needed for minimal contraction of upper or lower
limb because of their muscle size. Induced muscle contraction may lead to myokine secretion
and beneficial metabolic and anti-inflammatory effect. Stimulation on Quadriceps may be
better than on Biceps.
Participant: adult(older than 20 years-old) patients with severe sepsis.septic shock and
acute respiratory failure post mechanical ventilation.
Design: Stratified ( gender and age >50 years-old) Randomized parallel 3 arms study.
Intervention: Daily stimulation of Biceps of Quadriceps after third days in intensive care
unit. Programmed electric stimulation device ( HELEX 573 model, strength aggressive. mode,
45-55Hz 32 minutes per day, voltage 30-70mA)
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