Effects of intermittent electrical stimulations on muscle catabolism in intensive care patients

To determine whether muscular contractions obtained by electrical stimulation in immobilized patients are able to reduce muscle catabolism, we studied 10 patients (65-79 yr old) 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, intermittent electrical stimulation of the muscles of the legs (external electrodes), were performed daily during 2 X 30 mn. During the other period, muscular stimulations were not performed. Urinary excretion of nitrogen (micro-Kjeldhal digestion and Nessler procedure), creatinine (Jaffe reaction), and 3-methyl histidine (3-MH) (gas phase chromatography) was measured every day. (table; see text) We conclude that a significant decrease in 3-MH and creatinine excretion is observed during the MS period. In intensive care unit patients, muscle protein breakdown may be influenced by intermittent muscular electrical stimulation.