Título:	Efeitos da eletroestimulação neuromuscular sobre o tempo de internação de pacientes críticos em unidade de terapia intensiva : uma revisão sistemática com meta-análise
Autor(es):	Fonseca, Hellora Gonçalves
Orientador(es):	Silva, Vinícius Zacarias Maldaner da
Assunto:	Pacientes críticos Ventilação mecânica
Data de publicação:	25-Jun-2026
Data de defesa:	26-Mar-2026
Referência:	FONSECA, Hellora Gonçalves. Efeitos da eletroestimulação neuromuscular sobre o tempo de internação de pacientes críticos em unidade de terapia intensiva: uma revisão sistemática com meta-análise. 2026. 55 f., il. Dissertação (Mestrado em Ciências da Reabilitação) — Universidade de Brasília, Brasília, 2026.
Abstract:	Introduction: Intensive care unit–acquired weakness (ICU-AW) largely results from prolonged immobilization and is associated with unfavorable outcomes, including prolonged ventilator weaning, longer hospital stays, and increased mortality. Neuromuscular electrical stimulation (NMES) is a safe strategy for non-mobilizable patients, with the potential to preserve muscle mass and improve peripheral strength, thereby contributing to the prevention of ICU-AW and the optimization of hospital outcomes. Objective: To evaluate the effects of NMES on the duration of mechanical ventilation, ICU length of stay, and hospital length of stay in randomized controlled trials involving critically ill patients. Methods: This systematic review was registered in PROSPERO (CRD42024509006) and conducted according to PRISMA guidelines. The research question was structured according to the PICO strategy: Population: critically ill adults receiving invasive mechanical ventilation in the ICU; Intervention: neuromuscular electrical stimulation applied to the diaphragm and/or peripheral muscles; Comparison: usual care, sham NMES, conventional physiotherapy, or different stimulation protocols; Outcomes: duration of mechanical ventilation, ICU length of stay, and total hospital length of stay. Randomized controlled trials were identified through searches in PubMed, Web of Science, LILACS, Cochrane, and SciELO databases in March 2025, with no restrictions on language or publication date. Study selection and data extraction were performed independently by two reviewers. Methodological quality was assessed using the PEDro scale. The analyses were performed using Review Manager (RevMan) software. When necessary, medians and interquartile ranges were converted to means and standard deviations using the Meta-Analysis Accelerator. The outcomes duration of mechanical ventilation, ICU length of stay, and hospital length of stay were included in the meta-analysis and analyzed using the mean difference (MD) with 95% confidence intervals. Results: Of the 481 studies identified, 22 randomized controlled trials published between 2009 and 2024 were included. Studies conducted in different countries, with a predominance of Brazilian publications, mainly evaluated NMES initiated in intensive care units and combined with conventional physiotherapy. The meta-analysis demonstrated a significant reduction in the duration of mechanical ventilation with NMES compared with conventional treatment (MD = −7.01 days; 95% CI: −7.40 to −6.63; p < 0.00001), as well as a reduction in ICU length of stay (MD = −6.79 days; 95% CI: −7.26 to −6.32), although with extreme heterogeneity (I² = 98%). In contrast, total hospital length of stay favored the control group (MD = 5.51 days; 95% CI: 4.02 to 7.00), with high inconsistency across studies (I² = 87%). Conclusion: The results of this systematic review and meta-analysis indicate that neuromuscular electrical stimulation, when combined with conventional physiotherapy, is associated with reduced duration of mechanical ventilation and ICU length of stay in critically ill patients. These findings suggest that NMES may represent a relevant adjunctive strategy in the management of critically ill patients; however, future studies should prioritize the standardization of stimulation parameters and the evaluation of long-term functional outcomes.
Unidade Acadêmica:	Faculdade de Ciências e Tecnologias em Saúde (FCTS) – Campus UnB Ceilândia
Informações adicionais:	Dissertação (mestrado) — Universidade de Brasília, Faculdade de Ceilândia, Programa de Pós-Graduação em Ciências da Reabilitação, 2025.
Programa de pós-graduação:	Programa de Pós-Graduação em Ciências da Reabilitação
Licença:	A concessão da licença deste item refere-se ao termo de autorização impresso assinado pelo autor com as seguintes condições: Na qualidade de titular dos direitos de autor da publicação, autorizo a Universidade de Brasília e o IBICT a disponibilizar por meio dos sites www.unb.br, www.ibict.br, www.ndltd.org sem ressarcimento dos direitos autorais, de acordo com a Lei nº 9610/98, o texto integral da obra supracitada, conforme permissões assinaladas, para fins de leitura, impressão e/ou download, a título de divulgação da produção científica brasileira, a partir desta data.
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