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

Abstract

To define the discriminatory characteristics of patients with sepsis or septic shock, as well as responders and non-responders to the NMES protocol. This was a sub-analysis of a randomized, controlled, double-blind clinical trial. An intensive care unit (ICU) at a private hospital. 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. 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). The SOMS and DEMMI could characterize responders to the NMES protocol, whereas the SOFA score did not correlate with responders.