Coexistence and Impact of Limb Muscle and Diaphragm Weakness at Time of Liberation from Mechanical Ventilation in Medical Intensive Care Unit Patients

• DOI: 10.1164/rccm.201602-0367oc
• Publication Date: 2016-06-16T20:47:21Z
• Authors: Martin Dres; Bruno-Pierre Dubé; Julien Mayaux; Julie Delemazure; Danielle Reuter; Laurent Brochard; Thomas Similowski; Alexandre Demoule
• Keywords: Diaphragm (acoustics)

Intensive care unit (ICU)- and mechanical ventilation (MV)-acquired limb muscle diaphragm dysfunction may both be associated with longer length of stay worse outcome. Whether they are two aspects the same entity or have a different prevalence prognostic impact remains unclear.To quantify coexistence these forms ICU-acquired weakness their on outcome.In patients undergoing first spontaneous breathing trial after at least 24 hours MV, was evaluated using twitch tracheal pressure in response to bilateral anterior magnetic phrenic nerve stimulation (a <11 cm H2O defined dysfunction) ultrasonography (thickening fraction [TFdi] excursion). Limb as Medical Research Council (MRC) score less than 48.Seventy-six were assessed trial: 63% had dysfunction, 34% weakness, 21% both. There significant but weak correlation between MRC (ρ = 0.26; P 0.03) TFdi 0.28; 0.01), respectively. Low (odds ratio, 0.60; 95% confidence interval, 0.45-0.79; < 0.001) 0.84; 0.76-0.92; independently weaning failure, not. Diaphragm higher ICU hospital mortality, duration MV stay.Diaphragm is twice frequent has direct negative The types only limited overlap.