NMES in Critically Ill Patients
NMES in Critically Ill Patients
Critically ill patients with a predicted prolonged ICU stay will receive neuromuscular
 electrical stimulation (NMES) of one quadriceps muscle. Whether the dominant or non-dominant
 side will be stimulated is chosen randomly by using opaque sealed envelopes. The patients
 will receive electrical stimulation for 1h for 7 consecutive days. The stimulated and
 non-stimulated side will be compared for it's thickness (by using ultrasound imaging), muscle
 strength if the patients are awake and cooperative (using the medical research council scale
 and handheld dynamometry) and a muscle biopsy will be taken. As a primary outcome the
 investigators hypothesize that electrical stimulation will preserve muscle mass with respect
 to the non-stimulated quadriceps. As secondary outcomes the investigators hypothesize that
 electrical stimulation can reduce muscle strength loss and leads to a better protein balance
 and thicker muscle fibers in the stimulated quadriceps.
Inclusion Criteria:

 -  All adult ICU patients with a predicted prolonged ICU stay

 Exclusion Criteria:

 -  Preexisting neuromuscular disease, polyneuropathy or myopathy (e.g. Guillain-Barré,
 myasthenia gravis, Amyotrophic Lateral Sclerosis, paraplegia, multiple sclerosis, …)

 -  Receiving neuromuscular blocking agents

 -  Musculoskeletal conditions of the pelvis and/or lower limb (e.g. fractures, skin
 disease )

 -  Focal neurological conditions of the pelvis and/or lower limb

 -  Skin disease (e.g. burns)

 -  Presence of a pace-maker or defibrillator

 -  Hemodynamic or Respiratory Instability, active cardiac ischemia

 -  High fever (>39°)

 -  Pregnancy

 -  Brain death

 -  Intracranial pressure >20 mmHg

 -  An anticipated fatal outcome

 -  Psychiatric disorders or severe agitation

 -  Re-admission to the ICU