College of Health Sciences, Department of Physical Therapy, University of Kentucky, 900 Rose Street, Wethington 204D, Lexington, KY 40536, United States.
Center of Excellence in Rural Health, Department of Physical Therapy, University of Kentucky, Lexington, KY, United States.
Am J Med Sci. 2021 Mar;361(3):310-318. doi: 10.1016/j.amjms.2020.09.018. Epub 2020 Oct 3.
Up to 66% of patients admitted to the intensive care unit (ICU) for acute respiratory failure (ARF) develop ICU-acquired weakness, which is diagnosed by muscle strength testing. Muscle power, different from strength, is an important determinant of function that is not a common focus in patients surviving critical illness. Therefore, the purpose of this study is to assess muscle power in survivors of ARF.
A cross-sectional observational study performed with survivors of ARF. Muscle power, strength and physical function were assessed 4-8 weeks post-hospital discharge. Cross sectional area and echogenicity of rectus femoris and tibialis anterior muscles were assessed using ultrasonography. Healthy community-dwelling adults were included for comparison.
12 survivors of ARF mean age of 55.6 ± 17.1 (66% male) and 12 healthy adults mean age of 51.6.1 ± 10.3 (66% male) participated in this study. Patients in the post-ARF group had a mean muscle power of 9.9 ± 3.5 W and 63.7 ± 31.6 W for 2-lb and 10% of body-weight loads, respectively. Compared to matched controls, power in ARF group was reduced by 43%. Muscle power in post-ARF group had moderate correlations with 5-times sit-to-stand testing (r = -0.644, P = 0.024), 4-m habitual gait speed (-0.780, P = 0.002), and 6-min walk distance (r = 0.589, P = 0.044).
Muscle power is significantly reduced in survivors of critical illness and associated with deficits in physical function. These preliminary findings may support therapeutic interventions aimed at improving muscle power to potentially increase functional benefit.
多达 66%因急性呼吸衰竭（ARF）入住重症监护病房（ICU）的患者会出现 ICU 获得性肌无力，这通过肌肉力量测试来诊断。肌肉力量不同于力量，它是功能的一个重要决定因素，但在重症疾病存活患者中并非常见关注点。因此，本研究的目的是评估 ARF 幸存者的肌肉力量。
这是一项 ARF 幸存者的横断面观察性研究。在出院后 4-8 周时评估肌肉力量、肌肉力量和身体功能。使用超声评估股直肌和胫骨前肌的横截面积和超声回声。纳入健康的社区居住成年人进行比较。
12 名 ARF 幸存者，平均年龄 55.6±17.1 岁（66%为男性），12 名健康成年人，平均年龄 51.6.1±10.3 岁（66%为男性）参与了这项研究。ARF 后组患者的肌肉力量分别为 9.9±3.5 W 和 63.7±31.6 W，用于 2 磅和 10%体重负荷。与匹配的对照组相比，ARF 组的力量降低了 43%。ARF 组的肌肉力量与 5 次坐立测试（r=-0.644，P=0.024）、4 米习惯性步行速度（-0.780，P=0.002）和 6 分钟步行距离（r=0.589，P=0.044）呈中度相关。
危重病幸存者的肌肉力量显著降低，与身体功能缺陷相关。这些初步发现可能支持旨在提高肌肉力量的治疗干预措施，以潜在增加功能益处。
