This retrospective sub-analysis aimed to outline the characteristics of, as well as predictors for, a contractile response to Neuromuscular Electrical Stimulation (NMES), and also potential clinical benefits resulting from an adequate response to NMES.

This is a sub-analysis of a randomised controlled trial investigating early muscle activating measures together with protocol-based physiotherapy in patients with a SOFA score ≥ 9 within the first 72 h after admission.

Different muscle groups as well as different patients show a varying response to NMES, which appears to be dependent on multiple factors that are linked to the respective pathomechanisms behind the development of the ICU-acquired weakness.

Since we observed a varying degree of clinical improvement when comparing patients that responded adequately to NMES to those who did not, it is strongly suggested that response rates to NMES should be reported in future trials and evaluated in relation to clinical outcomes.

The described difference in response rates to NMES may explain the controversial findings of previous trials and improve the quality of evidence in future critical care NMES trials.

1,824 neuromuscular electrical stimulations in 21 patients starting on day 3.0 after ICU admission were included in this sub-analysis.

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