Clinical Research Directory

Inclusion Criteria: * Patients will be eligible if they are 18 years or older, are under invasive mechanical ventilation (IMV), and are expected to require IMV for more than 48 hours. Exclusion Criteria: * Body mass index (BMI) greater than or equal to 35 kg/m²; * Length of ICU stay longer than 7 ICU-free days or more than 3 continuous days of invasive mechanical ventilation (IMV) before enrollment; * Known intracranial process (e.g., stroke, intracranial hypertension); * Neuromuscular disease (e.g., Guillain-Barré syndrome, myasthenia gravis) at ICU admission; * Inability to speak Portuguese or pre-existing cognitive impairment prior to ICU admission; * Any condition that prevents neuromuscular electrical stimulation (NMES) treatment or assessment of the primary outcome in both legs (e.g., skin lesions, fractures, or amputation); * inability to transfer from bed to chair with or without assistance prior to hospital admission; * Cardiac arrest as the cause of ICU admission or cardiac arrest before screening; * Deep vein thrombosis (DVT) or pulmonary embolism (PE) treated for less than 48 hours; * Pregnant patients; * Known or suspected malignancy in the legs; * Any care limitation including a do-not-resuscitate order.