Impact of neuromuscular electrical stimulation (NMES) on duration of mechanical ventilation in ICU patients: A systematic review and meta-analysis

Background: Intensive care unit acquired weakness (ICUAW) is associated with prolonged mechanical ventilation (PMV), increasing risk and mortality in intensive care unit (ICU) patients. Early mobilization along with neuromuscular electrical stimulation (NMES), has shown potential in reducing mechanical ventilation duration, but remains inconclusive. This study evaluates the impact NMES on the mechanical ventilation duration in ICU patients. Methodology: A systematic literature search was conducted using Cochrane, EBSCOhost, Scopus, and PubMed databases, employing specific keywords and Boolean operators. The inclusion criteria were randomized controlled trials (RCTs) assessing NMES and the duration of mechanical ventilation. The included studies were evaluated for bias using the Cochrane Risk of Bias tool 2.0 (RoB 2). The effect size was estimated using a random-effects model in Review Manager 5.4 software. Results: A total of 320 patients from 9 RCTs were included in this meta-analysis. Pooled data indicated that NMES administration significantly reduced the duration of mechanical ventilation (MD-1.68 days; 95% CI:-3.09 to-0.27, P = 0.02), with moderate heterogeneity (I-2 = 30%). Conclusion: NMES administration appears to reduce the mechanical ventilation duration in ICU patients. However, further large-scale RCTs and inclusion of grey literature are necessary to confirm these findings.