Source: Annual Congress 2005 - Skeletal muscles: current concepts
Disease area: Airway diseases, Respiratory critical care

Abstract

BACKGROUND The severity and distribution of muscle weakness in critical illness is poorly documented. AIMS To assess inspiratory and hand muscle strength in critically ill patients. To assess factors associated with diaphragm weakness. METHODS Patients who had been in ICU for more than 5 days, and who were clinically stable, were enrolled. Strength was assessed using non-volitional (Twitch transdiaphragmatic pressure: TwPdi and Twitch adductor pollicis tension: TwAP) or volitional measures (maximum of maximal inspiratory pressure: PImax or sniff nasal inspiratory pressure: SNIP and hand grip strength) measures. Assessments were made in ICU, HDU and within the first week of transfer. RESULTS Compared to normal values, mean strength was reduced for all measures: mean (SD) TwPdi was 28.2(6.60) vs 11.5(5.17) cm H20, TwAP was 8.02(2.06) vs 5.28(2.06) N, MIP/SNIP 108(27.6) vs 37.6(16.8) cm H20, Hand Grip 37.1(9.93) vs 14.1(9.20) kg, p<0.00l). TwAP was related to TwPdi (p< 0.001), but the variability of TwAP precludes prediction of TwPdi in individual patients. The TwPdi/TwAP was reduced in ICU patients (p=0.001). Diaphragm weakness (TwPdi) was associated with steroids, SIRS and weaning failure (p<0.05 for all). CONCLUSIONS Both inspiratory and hand muscle strength are reduced in critically ill patients. The diaphragm is more susceptible to weakness in ICU. Inspiratory weakness relates to hand weakness, steroids, SIRS and weaning.

Rating:

Share or cite this content

Citations should be made in the following way:
J. Pickles, E. Kondili, G. Harikumar, W. Bernal, J. Wendon, M. Ervine, M. I. Polkey, J. Moxham (London, United Kingdom). Skeletal muscle strength in critical illness. Eur Respir J 2005; 26: Suppl. 49, 1667

Member's Comments

No comment yet.

Related content which might interest you: Pectoralis muscle area and skeletal muscle strength in patients with ILD Source: International Congress 2016 – From cardiopulmonary interaction to locomotor muscles and dyspnoea in health and disease Year: 2016 Isokinetic skeletal muscle strength in normal and COPD Source: Eur Respir J 2001; 18: Suppl. 33, 83s Year: 2001 Analysis of different equations to predict quadriceps femoris muscle strength in patients with COPD Source: International Congress 2015 – Respiratory physiotherapy assessment and techniques in COPD and asthma Year: 2015 Muscle morphology, metabolism and muscle function: general principles Source: ISSN=1025-448x, ISBN=1-904097-27-8, page=86 Year: 2003 The relationships between functional exercise capacity, respiratory muscle strength, peripheral muscle strength and endurance in patients with metabolic syndrome Source: Annual Congress 2013 –Assessment methods involved in the physiotherapy treatment in different patient populations Year: 2013 Fatiguing inspiratory muscle work accelerates limb muscle fatigue Source: Eur Respir J 2005; 26: Suppl. 49, 571s Year: 2005 Features of skeletal muscle dysfunction in COPD patients with obesity Source: International Congress 2015 – COPD: chronic disease and comorbidities Year: 2015 The clinical impact of skeletal muscle dysfunction Source: Annual Congress 2008 - PG3 - Respiratory physiology: respiratory and peripheral muscle function in health and disease Year: 2008 Exercise capacity, muscle strength and fatigue in sarcoidosis Source: Eur Respir J 2011; 38: 628-634 Year: 2011 Quadriceps strength is not related to inspiratory muscle strength in patients with COPD Source: Eur Respir J 2002; 20: Suppl. 38, 497s Year: 2002 Overweight and obesity influence on respiratory muscle strength Source: International Congress 2016 – Postural balance, respiratory muscles, and comorbidities in chronic respiratory disease Year: 2016 Skeletal muscle inflammatory markers in COPD patients with muscle wasting Source: Annual Congress 2010 - Novel markers of lung injury Year: 2010 Skeletal muscle mass predicts strength but not endurance in upper and lower limbs in patients with COPD Source: Eur Respir J 2001; 18: Suppl. 33, 187s Year: 2001 Effects of electrical muscle stimulation early in the quadriceps and tibialis anterior muscle of critically ill patients Source: Annual Congress 2013 –Exercise and physiotherapy in non-COPD conditions and in the assessment of healthy subjects Year: 2013