- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04382378
Effects of NMES in Critically Ill Patients (NUMBERNMES)
March 11, 2021 updated by: Vinicius Zacarias Maldaner da silva, Escola Superior de Ciencias da Saude
Effects of Different Regimen Protocols of NMES in COVID 19 Critically Ill Patients
Muscle wasting occurred early and rapidly in critically ill patients.
Early therapeutic strategies to either maintain muscle structure and function should be encouraged.
Neuromuscular electrical stimulation (NMES) is an attractive intervention to maintain muscle mass and strength in critically ill patients during the first week of ICU stay.
This study will test the hypothesis that the number of contraction per day evoked by NMES in the first two weeks of illness may influence in muscle wasting, with beneficial effects on the physical and functional status in mechanically ventilated patients.
Study Overview
Status
Recruiting
Intervention / Treatment
Detailed Description
Patients with prolonged mechanical ventilation require deep sedation and mechanical ventilation, factors predisposing to the development of skeletal muscle wasting and acute muscle atrophy.
Strategies to attenuate this process must be used.
The neuromuscular electrostimulation (NMES) leads to the application of electrical currents in the skin aiming at muscle contraction, has beneficial effects for the population of critical patients.
However, the number of contractions induced by NMES to attenuate the loss of muscle mass in this population is not yet established.
This randomized controlled trial with 120 patients that will be randomized to one of the 3 study groups: 100 continuous daily contractions (100Cd), 50 continuous daily contractions (50Cd) and control group.
Muscle thickness, NMES-induced strength, and clinical and functional parameters at the time of discharge from the ICU and hospital discharge will be assessed daily.
The results of this project will provide an important contribution to the understanding of the mechanisms associated with NMES treatment as a tool to minimize the effects of muscle disuse, as well as providing scientific support for the clinical use of this resource in the treatment in the light of the policies' health system.
Study Type
Interventional
Enrollment (Anticipated)
120
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: VINICIUS ZACARIAS MALDANER D SILVA
- Phone Number: 6135462517
- Email: viniciusmaldaner@gmail.com
Study Locations
-
-
DF
-
Brasilia, DF, Brazil, 700000
- Recruiting
- Secretaria de Saúde do Distrito Federal
-
Contact:
- Vinicius Silva, PhD
- Phone Number: +55 61 20172145
- Email: viniciius.maldaner@escs.edu.br
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Aged 18 years or older
- Intubated and expected to remain invasively mechanically ventilated the day after tomorrow
- laboratory confirmed COVID-19 (diagnosis of SARS-CoV-2 via reverse transcriptase polymerase chain reaction as per the World Health Organization protocol or by nucleic acid based isothermal amplification)
Exclusion Criteria:
- Dependent for activities of daily living in the month prior to current ICU admission (gait aids are acceptable).
- Documented cognitive impairment.
- Proven or suspected spinal cord injury or other neuromuscular disease that will result in permanent or prolonged weakness (not including ICU acquired weakness)
- Death is deemed inevitable as a result of the current illness and either the patient or treating clinical or substitute decision maker are not committed to full active treatment
- pregnancy
- patients with unstable fractures in the vertebral column and lower limbs.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: control group
Group that will receive a standard care from physiotherapy staff not involved in delivering the intervention whenever feasible.
|
|
Experimental: 50 electrically evoked contractions
Group that will receive a standard care from physiotherapy staff plus neuromuscular electrical stimulation with the following parameters: pulsed current; freqeuncy 50Hz; pulse witdh 400 us, current intensity that get level 4/5 of evoked contractions proposed by Segers et al; on/off time and duration of therapy that allow 50 ellectrically evoked contractions with surface electrodes positioned on the quadriceps femoris.
|
application of an electric current through electrodes placed on the skin over the targeted musclesto induce skeletal muscle contractions
Other Names:
|
Experimental: 100 electrically evoked contractions
Group that will receive a standard care from physiotherapy staff plus neuromuscular electrical stimulation with the following parameters: pulsed current; freqeuncy 50Hz; pulse witdh 400 us, current intensity that get level 4/5 of evoked contractions proposed by Segers et al; on/off time and duration of therapy that allow 100 ellectrically evoked contractions with surface electrodes positioned on the quadriceps femoris.
|
application of an electric current through electrodes placed on the skin over the targeted musclesto induce skeletal muscle contractions
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
cross sectional area of rectus femoris
Time Frame: from baseline to 14 days of therapy
|
change of muscle wasting assessed by ultrassonogropahy
|
from baseline to 14 days of therapy
|
echointensity of rectus femoris
Time Frame: from baseline to 14 days of therapy
|
change of echointensity of rectus femoris assessed by ultrassonography
|
from baseline to 14 days of therapy
|
muscle strength
Time Frame: from baseline to 14 days of therapy
|
change of evoked peak torque of quadriceps femoris assesssed by unvolitional testing
|
from baseline to 14 days of therapy
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Functional status
Time Frame: from baseline to 14 days of therapy
|
Functional status assessed by IMS scale ranged from 0 to 10
|
from baseline to 14 days of therapy
|
ICU acquired weakness
Time Frame: from baseline to 14 days of therapy
|
percent of patients that have muscle strength assessed by Medical Research Council Sum-Score (MRC-SS) lower than 48
|
from baseline to 14 days of therapy
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: VINICIUS ZACARIAS MALDANER D SILVA, Secretaria de Saúde do Distrito Federal
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 1, 2021
Primary Completion (Anticipated)
September 30, 2021
Study Completion (Anticipated)
December 31, 2021
Study Registration Dates
First Submitted
May 4, 2020
First Submitted That Met QC Criteria
May 8, 2020
First Posted (Actual)
May 11, 2020
Study Record Updates
Last Update Posted (Actual)
March 15, 2021
Last Update Submitted That Met QC Criteria
March 11, 2021
Last Verified
March 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Nervous System Diseases
- Coronavirus Infections
- Coronaviridae Infections
- Nidovirales Infections
- RNA Virus Infections
- Virus Diseases
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Pneumonia, Viral
- Pneumonia
- Lung Diseases
- Neurologic Manifestations
- Musculoskeletal Diseases
- Muscular Diseases
- Neuromuscular Manifestations
- COVID-19
- Muscle Weakness
Other Study ID Numbers
- FAP042017
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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