Oxidative stress and immune system analysis after cycle ergometer use in critical patients

Eduardo Eriko Tenório de França, Luana Carneiro Ribeiro, Gabriela Gomes Lamenha, Isabela Kalline Fidelix Magalhães, Thainá de Gomes Figueiredo, Marthley José Correia Costa, Ubiracé Fernando Elihimas Júnior, Bárbara Luana Feitosa, Maria do Amparo Andrade, Marco Aurélio Valois Correia Júnior, Francimar Ferrari Ramos, Célia Maria Machado Barbosa de Castro, Eduardo Eriko Tenório de França, Luana Carneiro Ribeiro, Gabriela Gomes Lamenha, Isabela Kalline Fidelix Magalhães, Thainá de Gomes Figueiredo, Marthley José Correia Costa, Ubiracé Fernando Elihimas Júnior, Bárbara Luana Feitosa, Maria do Amparo Andrade, Marco Aurélio Valois Correia Júnior, Francimar Ferrari Ramos, Célia Maria Machado Barbosa de Castro

Abstract

Objective:: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients.

Methods:: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães. The patients were divided into two groups: one group underwent cycle ergometer passive exercise for 30 cycles/min on the lower limbs for 20 minutes; the other group did not undergo any therapeutic intervention during the study and served as the control group. A total of 20 ml of blood was analysed, in which nitric oxide levels and some specific inflammatory cytokines (tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukins 6 (IL-6) and 10 (IL-10)) were evaluated before and after the study protocol.

Results:: Regarding the demographic and clinical variables, the groups were homogeneous in the early phases of the study. The nitric oxide analysis revealed a reduction in nitric oxide variation in stimulated cells (p=0.0021) and those stimulated (p=0.0076) after passive cycle ergometer use compared to the control group. No differences in the evaluated inflammatory cytokines were observed between the two groups.

Conclusion:: We can conclude that the passive cycle ergometer promoted reduced levels of nitric oxide, showing beneficial effects on oxidative stress reduction. As assessed by inflammatory cytokines, the treatment was not associated with changes in the immune system. However, further research in a larger population is necessary for more conclusive results.

Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
Illustration of passive cycle ergometer application on lower limbs in critical patients under mechanical ventilation.
Figure 2
Figure 2
Flowchart of the patients who participated in the study.
Figure 3a and 3b
Figure 3a and 3b
Variation in the nitric oxide (NO) values in stimulated control positive cell (C +) and unstimulated in the two groups studied: control and passive cycle ergometer. * Mann-Whitney Test. Differences between the control group and cycle ergometer 3a. (*p=0.0021) and 3b. (*p=0.0076).

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Source: PubMed

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