Wang T-H1, Wang L-Y2, Wu C-P3
1National Taiwan University / Landseed Hospital, Department of Critical Care Medicine, Taoyuan, Taiwan, 2National Taiwan University, School and Graduate Institute of Physical Therapy, College of Medicine, Taipei, Taiwan, 3Landseed Hospital, Department of Critical Care Medicine, Taoyuan, Taiwan
Background: Peripheral muscle weakness is common in critically ill patients with mechanical ventilator. Evidence from previous studies showed that peripheral muscle strength is associated with weaning outcome. However, the predictive value of peripheral muscle strength on extubation outcome from mechanical ventilation has not been investigated.
Purpose: The purpose of this study was to evaluate the relationship between peripheral muscle strength and extubation failure among patients in an intensive care unit (ICU).
Methods: ICU patients who were mechanically ventilated for more than 48 hrs and were planning to wean according to standard protocol were enrolled in this study. Limb muscle strength was assessed using the hand-held dynamometer on the day of planned extubation. Association of limb muscle strength and extubation failure, defined as re-intubation within 48 hrs following planned extubation, was evaluated with logistic regression analysis.
Results: Ten subjects (60% males) were included with a mean (±SD) age of 68.4±(12.5) years and a mean (±SD) Acute Physiology and Chronic Health Evaluation (APACHE) II score of 18.2±8.5. The mean (±SD) length of ICU stay was 12.1±(7.9). Extubation failure occurred in 2 (20%) patients. Mean biceps strength tended to be lower in patients with extubation failure (11.0±7.1 kg) than in patients without extubation failure (15.3±4.1 kg). Mean quadriceps strength were also lower in patients with extubation failure (8.0±2.8 kg) than in patients without extubation failure (14.1±4.2 kg). In addition, biceps (r = 0.756, p = 0.011) and quadriceps (r = 0.694, p = 0.026) strength correlated significantly with lung compliance.
Conclusion(s): The preliminary results of the study suggested that peripheral muscle strength at the time of extubation may be a valuable predictor for extubation outcome.
Implications: Future studies with larger sample sizes are needed to confirm the predictive value of peripheral muscle strength for extubation outcome. Whether early detection and prevention of peripheral muscle weakness in ICU patients will improve extubation warrants further investigations.
Keywords: extubation outcome, peripheral muscle strength, mechanical ventilation
Funding acknowledgements: The author(s) received no financial support for the research.
Purpose: The purpose of this study was to evaluate the relationship between peripheral muscle strength and extubation failure among patients in an intensive care unit (ICU).
Methods: ICU patients who were mechanically ventilated for more than 48 hrs and were planning to wean according to standard protocol were enrolled in this study. Limb muscle strength was assessed using the hand-held dynamometer on the day of planned extubation. Association of limb muscle strength and extubation failure, defined as re-intubation within 48 hrs following planned extubation, was evaluated with logistic regression analysis.
Results: Ten subjects (60% males) were included with a mean (±SD) age of 68.4±(12.5) years and a mean (±SD) Acute Physiology and Chronic Health Evaluation (APACHE) II score of 18.2±8.5. The mean (±SD) length of ICU stay was 12.1±(7.9). Extubation failure occurred in 2 (20%) patients. Mean biceps strength tended to be lower in patients with extubation failure (11.0±7.1 kg) than in patients without extubation failure (15.3±4.1 kg). Mean quadriceps strength were also lower in patients with extubation failure (8.0±2.8 kg) than in patients without extubation failure (14.1±4.2 kg). In addition, biceps (r = 0.756, p = 0.011) and quadriceps (r = 0.694, p = 0.026) strength correlated significantly with lung compliance.
Conclusion(s): The preliminary results of the study suggested that peripheral muscle strength at the time of extubation may be a valuable predictor for extubation outcome.
Implications: Future studies with larger sample sizes are needed to confirm the predictive value of peripheral muscle strength for extubation outcome. Whether early detection and prevention of peripheral muscle weakness in ICU patients will improve extubation warrants further investigations.
Keywords: extubation outcome, peripheral muscle strength, mechanical ventilation
Funding acknowledgements: The author(s) received no financial support for the research.
Topic: Critical care; Cardiorespiratory; Outcome measurement
Ethics approval required: Yes
Institution: Landseed Hospital, Taoyuan, Taiwan
Ethics committee: Landseed Hospital ethics institutional research committee
Ethics number: 14-027-B1
All authors, affiliations and abstracts have been published as submitted.
