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Objective:The early use of neuromuscular electrical stimulation (NMES) to prevent intensive care unit-acquired weakness (ICU-AW) in critical patients is still a controversial topic.We conducted a systematic review to clarify the effectiveness of NMES in preventing ICU-AW.Methods:The Cochrane Library,PubMed,EMBASE,MEDUNE,Web of Science,Ovid,CNKI,Wanfang,VIP,China Biology Medicine disc (CBMdisc) and other databases were searched for randomized controlled trials on the influence of NMES on ICU-AW.The studies were selected according to the inclusion and exclusion criteria.After data and quality were evaluated,a meta-analysis was performed by RevMan 5.3 software.Results:A total of 11 randomized controlled trials with 576 patients were included.The meta-analysis results showed that NMES can improve muscle strength [MD =1.78,95% CI (0.44,3.12,P =0.009);shorten the mechanical ventilation (MV) time [SMD =-0.65,95% CI (-1.03,-0.27,P =0.001],ICU length of stay [MD =-3.41,95% CI (-4.58,-4.24),P < 0.001],and total length of stay [MD =-3.97,95% CI (-6.89,-1.06,P =0.008];improve the ability of patients to perform activities of daily living [SMD =0.9,95% CI (0.45,1.35),P =0.001];and increase walking distance [MD =239.03,95% CI (179.22298.85),P < 0.001].However,there is no evidence indicating that NMES can improve the functional status of ICU patients during hospitalization,promote the early awakening of patients or reduce mortality (P > 0.05).Conclusion:Early implementation of the NMES intervention in ICU patients can prevent ICU-AW and improve their quality of life by enhancing their muscle strength and shortening the MV duration,length of stay in the ICU and total length of stay in the hospital.