Effect of transcutaneous electrical nerve stimulation on renal tissue perfusion and hemodynamic stability for patients with hypovolemic shock: A randomized controlled trial

Document Type : Original Article

Authors

1 Assistant professor, Critical care and emergency nursing Department, Faculty of Nursing, Assiut University, Assiut, Egypt.

2 Lecturer, Critical care and emergency nursing Department. Faculty of Nursing, Sohag University, Sohag, Egypt.

3 Associate professor, Anesthesia and intensive care Department, Faculty of medicine, Assiut University, Assiut, Egypt.

4 Lecture, Clinical pathology Department, Faculty of medicine, Assiut University, Assiut, Egypt.

5 Consultant of Anesthesia, King Saud University (KSMC), KSA

6 Lecturer, Anesthesia and intensive care department, Faculty of medicine, Assiut University, Assiut, Egypt.

Abstract

 Background: Transcutaneous electrical nerve stimulation (TENS) is widely practiced method to increase blood flow in clinical practice as some authors have observed that, in addition to its analgesic effects, TENS can alter skin temperature and increase blood flow. Objective: Was to evaluate the effect of transcutaneous electrical nerve stimulation application on the renal tissue perfusion and hemodynamic stability for patients with hypovolemic shock. Methods: A prospective, single-blind, randomized, controlled trial was conducted as patients were randomized into two groups (active TENS (intervention group) and sham TENS (control group). Active TENS group received resuscitation protocol and transcutaneous electrical nerve stimulation while sham TENS group received resuscitation protocol only. Data was collected from ICU. Improvement of renal tissue perfusion was considered the primary outcome and secondary outcomes was improvement of hemodynamic parameters. Results: TENS application had caused a highly statistical significant change in serum creatinine and NGAL test (74.43 ± 7.16 in intervention group versus 114.48 ± 13.6 2 in control group) and (7.35 ± 0.7716 in intervention group versus 20.76 ± 2.11 in control group (P = 0.007 & P= 0.000) respectively. There was highly statistical significant difference before treatment and after treatment regarding urea, creatinine and NGAL test in the control group (P= 0.002 & P= 0.006& P= 0.000) respectively and there was highly statistical significant difference before treatment and after treatment in TENS group regarding to serum creatinine (P= 0.003). Conclusion: Application of transcutaneous electrical nerve stimulation had significant improvement for renal tissue perfusion and hemodynamic parameters. Recommendation: TENS should be included as one of the ICU therapeutic modalities to improve patient's outcomes. 

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