Critical Illness Polyneuromyopathy - The effect of electrical nerve stimulation.

Muscle weakness in patients admitted to the Intensive Care Unit (ICU) lengthens duration of mechanical ventilation, weaning and hospital stay. One of the causes for muscle weakness is critical illness polyneuromyopathy (CIPM). The incidence of CIPM varies between 25 and 100%, depending on patient population, diagnostic criteria and timing of measurements. Despite many previous studies, the pathophysiology and risk factors of CIPM remain unclear. More importantly, there is yet no therapy for this disease. Electrical stimulation has shown to improve muscle strength, cross-sectional area of muscle and prevent muscle atrophy. We hypothesize that electrical stimulation of nerves in patients with CIPM will improve muscle strength.
Patients who are expected to be admitted to the thoracic ICU for longer than 2 days will be included in this study. Some of these patients will develop CIPM. Patients will receive muscle force measurements of the M. extensor hallucis longus on day 0. On day 1-10 muscle force and electrophysiological measurements will take place daily. On day 1-9 electrical stimulation of the N. peroneus communis on one leg will be applied for 30 minutes. Randomization determines which leg will be stimulated (dominant or non-dominant). The primary outcome measure is the difference in muscle force (percentage) between stimulated and non-stimulated legs on day 1 and day 10. Also, electrophysiological measurements will be evaluated.

Muscle weakness in patients admitted to the Intensive Care Unit lengthens duration of mechanical ventilation, weaning and hospital stay. One of the causes for muscle weakness is critical illness polyneuromyopathy (CIPM). The incidence of CIPM varies between 25 and 100%, depending on patient population, diagnostic criteria and timing of measurements. Despite many previous studies, the pathophysiology and risk factors of CIPM remain unclear. More importantly, there is yet no therapy for this disease. Electrical stimulation has shown to improve muscle strength, cross-sectional area of muscle and prevent muscle atrophy. We hypothesize that electrical stimulation of nerves in patients with CIPM will improve muscle strength.

Patients will receive muscle force measurements of the M. extensor hallucis longus on day 0. On day 1-10 muscle force and electrophysiological measurements will take place daily. On day 1-9 electrical stimulation of the N. peroneus communis will be applied.

Electrical nerve stimulation of the N. peroneus communis on one leg. Randomization determines whether the dominant or non-dominant leg is stimulated. Stimulation will be applied daily for 30 minutes on 9 weekdays.