Effects of Intermittent Electrical Stimulations on muscle catabolism in Intensive Care patients

Bouletrau et al, 1987 [n=10; male and female; from 65 to 79 years old] aimed to determine whether muscular contractions obtained by electrical stimulation in immobilized patients can reduce muscle catabolism. Participants were hospitalized in the intensive care unit for postoperative ventilatory failure or cerebral infarction. Artificial nutrition was the same for each patient during the 9-day study period. Two periods of 4 days were defined and randomized for each patient, separated by one day. During the muscular stimulation (MS) period, patients had the same physiotherapy but, in addition, IES of the legs were performed with a Dynavein stimulator (Tage). Electrodes were placed under the calves, voltage was tested (from 0 to 120 volts) to obtain contraction of both calves and thighs, and stimuli 3 msec long, at a frequency of 1.75 Hz (105 per min), with an inversion of Polaritv everv 5 sec. were delivered during 30 min in the morning and 30 min in the evening. During the non-stimulated period (4 days), the patient was entirely hypokinetic, except during physiotherapy usually performed in the unit. No difference in nitrogen balance, urea, creatinine, and 3-MH elimination was found between the first, second, third, and fourth day of stimulation (time, correlation analysis). During the stimulated period, the excretion of 3-MH and of creatinine is significantly lower. There is a good correlation between the daily excretion of creatinine and 3-MH (r = 0.68, p < 0.01) and between 3-MH and nitrogen balance (r = -0.66, p < 0.01). We conclude that a significant decrease in 3-methyl histidine (3-MH) and creatinine excretion is observed during the MS period. The authors concluded that in intensive care unit patients, muscle protein breakdown may be influenced by IES. Thus, this technique, which is easy to utilize, may have beneficial effects on muscle metabolism in patients subjected to prolonged hypokinesia, its effects on whole body nitrogen economy remain unclear.