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dc.contributorFaculty of Health and Social Sciencesen_US
dc.contributor.advisorNg, Gabriel (RS)-
dc.creatorLee, Chun Kit-
dc.identifier.urihttps://theses.lib.polyu.edu.hk/handle/200/9907-
dc.languageEnglishen_US
dc.publisherHong Kong Polytechnic University-
dc.rightsAll rights reserveden_US
dc.titlePreserving the limbs muscle bulk for patients with critical illness on mechanical ventilation in ICUen_US
dcterms.abstractObjective: The present study aimed to examine the effect of early neuromuscular electrical stimulation (NMES) treatment in patients admitted to an intensive care unit (ICU) who are on mechanical ventilation. There were three outcome measures, namely, (1) the quadriceps and biceps muscle size in terms of cross-sectional thickness (CSD) and area (CSA), (2) the quality of life and functional status of those patients receiving NMES at discharge from ICU, and (3) the length of stay in ICU and in hospital, and also the number of patients diagnosed with ICU acquired weakness at discharge from ICU. Methods: Forty-nine patients under mechanical ventilation in an ICU were recruited within 48 hours after ICU admission. Informed consent was obtained if patients were awake. For those who were sedated or in a state of coma, consents were obtained from their legal guardian/legally authorized representatives. Once the patients regained consciousness, they would be asked to provide consent before the study continued. Patients were randomly assigned with one limb for NMES treatment and the other limb acted as control without intervention. The NMES treatment was applied to the quadriceps and biceps muscles for 30 minutes per day over 5 consecutive days. The CSD and CSA of quadriceps femoris and biceps brachii muscles were measured by using high-resolution real-time ultrasonography on Day 1 and 5 of intervention and one week after the end of treatment. Demographical data and APACHE II score were collected on ICU admission. Also, ICU length of stay and hospital length of stay were collected for this study. Results: On Day 5, thickness of the quadriceps and biceps muscles was 14.07% (P=0.04) and 15.01% (p=0.047) greater on the treated limbs than the control limbs. The cross-sectional area of quadriceps was 8.65% (p=0.014) larger whereas the biceps was 9.63% (p=0.011) larger on the treated limbs than the control limbs. On Day 12, the mean CSD and CSA of quadriceps and biceps muscle were still larger in the NMES treated limbs than the control limbs. However, the result was not statistically significant (p=0.051-0.151). For the functional assessment, the Functional Status Score for the Intensive Care Unit (FSS-ICU) scores were significantly lower (p<0.01) at discharge from ICU with a median (interquartile range) of 35 versus 24 (11.5-27). The mean (SD) of Physical Component Summary (PCS) and Mental Component Summary (MCS) of SF-36 were 35.45 ± 6.72 and 35.34 ± 4.11, respectively. Conclusion: Early application of NMES for patients on mechanical ventilation in ICU could effectively delay muscle atrophy and minimize the development of ICU acquired weakness.en_US
dcterms.extentxi, 134 pages : color illustrationsen_US
dcterms.isPartOfPolyU Electronic Thesesen_US
dcterms.issued2018en_US
dcterms.educationalLevelDHScen_US
dcterms.educationalLevelAll Doctorateen_US
dcterms.LCSHHong Kong Polytechnic University -- Dissertationsen_US
dcterms.LCSHElectric stimulationen_US
dcterms.LCSHMusclesen_US
dcterms.LCSHCritical care medicineen_US
dcterms.accessRightsrestricted accessen_US

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Please use this identifier to cite or link to this item: https://theses.lib.polyu.edu.hk/handle/200/9907