Faculty Collaboration Database

Peripheral muscle strength and correlates of muscle weakness in patients receiving mechanical ventilation. Am J Crit Care 2015 Nov;24(6):e91-8

Date

11/03/2015

Pubmed ID

26523017

Pubmed Central ID

PMC4631078

DOI

10.4037/ajcc2015277

Scopus ID

2-s2.0-84948771818 (requires institutional sign-in at Scopus site)   32 Citations

Abstract

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.

Author List

Chlan LL, Tracy MF, Guttormson J, Savik K

Author

Jill Guttormson BSN,MS,PhD Assistant Professor in the College of Nursing department at Marquette University

MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Aged
Aged, 80 and over
Critical Illness
Female
Hand Strength
Humans
Intensive Care Units
Length of Stay
Male
Middle Aged
Muscle Strength
Muscle Strength Dynamometer
Muscle Weakness
Respiration, Artificial
Severity of Illness Index
Sex Factors
Time Factors
Young Adult