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Magnetic twitch assessment of diaphragm and quadriceps weakness in critically ill mechanically ventilated patients
Respiratory Physiology & Neurobiology ( IF 2.3 ) Pub Date : 2021-09-21 , DOI: 10.1016/j.resp.2021.103789
Gerald S Supinski 1 , Paul F Netzel 1 , Philip M Westgate 2 , Elizabeth A Schroder 1 , Lin Wang 1 , Leigh Ann Callahan 1
Affiliation  

Critically ill mechanically ventilated (MV) patients develop significant muscle weakness, which has major clinical consequences. There remains uncertainty, however, regarding the severity of leg weakness, the precise relationship between muscle strength and thickness, and the risk factors for weakness in MV patients. We therefore measured both diaphragm (PdiTw) and quadriceps (QuadTw) strength in MV patients using magnetic stimulation and compared strength to muscle thickness. Both PdiTw and QuadTw were profoundly reduced for MV patients, with PdiTw 19 % of normal and QuadTw 6% of normal values. There was a poor correlation between strength and thickness for both muscles, with thickness often remaining in the normal range when strength was severely reduced. Regression analysis revealed reductions in PdiTw correlated with presence of infection (p = 0.006) and age (p = 0.007). QuadTw best correlated with duration of MV (p = 0.036). Limb muscles are profoundly weak in critically ill patients, with a severity that mirrors the level of weakness observed in the diaphragm.



中文翻译:

重症机械通气患者膈肌和股四头肌无力的磁颤动评估

重症机械通气 (MV) 患者会出现明显的肌肉无力,这会产生重大的临床后果。然而,关于腿部无力的严重程度、肌肉力量和厚度之间的精确关系以及 MV 患者无力的危险因素,仍然存在不确定性。因此,我们使用磁刺激测量了 MV 患者的隔膜 (PdiTw) 和股四头肌 (QuadTw) 强度,并将强度与肌肉厚度进行了比较。MV 患者的 PdiTw 和 QuadTw 均显着降低,PdiTw 为正常值的 19%,QuadTw 为正常值的 6%。这两种肌肉的力量和厚度之间的相关性很差,当力量严重下降时,厚度通常保持在正常范围内。回归分析显示 PdiTw 的减少与感染的存在 (p = 0.006) 和年龄 (p = 0.007) 相关。QuadTw 与 MV 持续时间的相关性最好 (p = 0.036)。重症患者的四肢肌肉极度虚弱,其严重程度反映了横膈膜无力的程度。

更新日期:2021-09-23
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