Peripheral muscle strength and correlates of muscle weakness in patients receiving mechanical ventilation.

Autor:	Chlan LL; Linda L. Chlan was the Dean's Distinguished Professor of Symptom Management Research, College of Nursing, Ohio State University, Columbus, Ohio at the time of this research. Mary Fran Tracy is a critical care clinical nurse specialist, University of Minnesota Medical Center, Fairview, Minneapolis, Minnesota. Jill Guttormson is an assistant professor, College of Nursing, Marquette University, Milwaukee, Wisconsin. Kay Savik is a senior statistician, School of Nursing, University of Minnesota, Minneapolis, Minnesota. chlan.linda@mayo.edu., Tracy MF; Linda L. Chlan was the Dean's Distinguished Professor of Symptom Management Research, College of Nursing, Ohio State University, Columbus, Ohio at the time of this research. Mary Fran Tracy is a critical care clinical nurse specialist, University of Minnesota Medical Center, Fairview, Minneapolis, Minnesota. Jill Guttormson is an assistant professor, College of Nursing, Marquette University, Milwaukee, Wisconsin. Kay Savik is a senior statistician, School of Nursing, University of Minnesota, Minneapolis, Minnesota., Guttormson J; Linda L. Chlan was the Dean's Distinguished Professor of Symptom Management Research, College of Nursing, Ohio State University, Columbus, Ohio at the time of this research. Mary Fran Tracy is a critical care clinical nurse specialist, University of Minnesota Medical Center, Fairview, Minneapolis, Minnesota. Jill Guttormson is an assistant professor, College of Nursing, Marquette University, Milwaukee, Wisconsin. Kay Savik is a senior statistician, School of Nursing, University of Minnesota, Minneapolis, Minnesota., Savik K; Linda L. Chlan was the Dean's Distinguished Professor of Symptom Management Research, College of Nursing, Ohio State University, Columbus, Ohio at the time of this research. Mary Fran Tracy is a critical care clinical nurse specialist, University of Minnesota Medical Center, Fairview, Minneapolis, Minnesota. Jill Guttormson is an assistant professor, College of Nursing, Marquette University, Milwaukee, Wisconsin. Kay Savik is a senior statistician, School of Nursing, University of Minnesota, Minneapolis, Minnesota.
Jazyk:	angličtina
Zdroj:	American journal of critical care : an official publication, American Association of Critical-Care Nurses [Am J Crit Care] 2015 Nov; Vol. 24 (6), pp. e91-8.
DOI:	10.4037/ajcc2015277
Abstrakt:	Background: Intensive care unit-acquired weakness is a frequent complication of critical illness because of patients' immobility and prolonged use of mechanical ventilation. Objectives: To describe daily measurements of peripheral muscle strength in patients receiving mechanical ventilation and explore relationships among factors that influence intensive care unit-acquired weakness. Methods: Peripheral muscle strength of 120 critically ill patients receiving mechanical ventilation was measured daily by using a standardized handgrip dynamometry protocol. Three grip measurements for each hand were recorded in pounds-force; the mean of these 3 assessments was used in the analysis. Correlates of intensive care unit-acquired weakness (age, sex, illness severity, duration of mechanical ventilation, medications) were analyzed by using mixed models to explore the relationship to grip strength. Results: Median baseline grip strength was variable yet diminished (7.7 pounds-force), with either a pattern of diminishing grip strength or maintenance of the baseline low grip strength over time. With controls for days of measurement, female sex (β = -10.4; P < .001), age (β = -0.24; P = .004), and days receiving mechanical ventilation (β = -0.34; P = .005) explained a significant amount of variance in grip strength over time. Conclusions: Patients receiving prolonged mechanical ventilation had marked decrements in grip strength, measured by hand dynamometry, a marker for peripheral muscle strength. Hand dynamometry is a reliable method for measuring muscle strength in cooperative critically ill patients and can be used to develop interventions to prevent intensive care unit-acquired weakness. (©2015 American Association of Critical-Care Nurses.)
Databáze:	MEDLINE
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