Department of Rehabilitation, University Hospital Brno, Brno 62500, Czech Republic.
Department of Rehabilitation, University Hospital Brno, Brno 62500, Czech Republic; Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic.
Heart Lung. 2023 Jul-Aug;60:95-101. doi: 10.1016/j.hrtlng.2023.03.007. Epub 2023 Mar 13.
The two most common symptoms associated with COVID-19 are dyspnea and fatigue. One possible cause of such symptoms may be inspiratory muscle weakness.
The purpose of this study was to examine inspiratory muscle performance (IMP) from intensive care unit discharge (ICUD) to hospital discharge (HD) in patients with COVID-19 hypothesizing that IMP would be markedly depressed at both ICUD and HD.
IMP was examined at ICUD and HD via the PrO2 device (PrO2 Health, Smithfield, RI) which provided the maximal inspiratory pressure (MIP), sustained MIP (SMIP), inspiratory duration (ID), and fatigue index test (FIT). Patient symptoms were assessed at ICUD, HD, and 1-month post-HD.
30 patients (19 men, 11 women) with COVID-19 were included. The mean±SD age, BMI, and length of ICU and hospital stay was 71±11 yrs, 27.9 ± 6.3 kg/m, 9 ± 6 days, and 26±16 days, respectively. The mean±SD MIP, SMIP, ID, and FIT of the entire cohort at ICUD vs HD were 36±21 vs 40±20 cm H2O, 231±157 vs 297±182 PTU, 8.8 ± 4.2 vs 9.5 ± 4.6 s, and 9.0 ± 9.4 vs 13.1 ± 12.3, respectively, with only SMIP and FIT significantly greater at HD (p=.006 and 0.03, respectively). SMIP at HD was significantly related to resting dyspnea at HD (r=-0.40; p=.02). The SMIP and FIT of men were found to increase significantly from ICUD to HD, but no measure of IMP in the women increased significantly from ICUD to HD. At least one COVID-19-related symptom was present 1 month after HD with the most persistent symptoms being fatigue, cough, and dyspnea in 47%, 40%, and 37% of the patients, respectively.
A significant reduction in IMP exists in patients with COVID-19 at both ICUD and HD and no measure of IMP in women was observed to increase significantly from ICUD to HD. Impaired inspiratory muscle endurance rather than strength was associated with greater dyspnea at HD.
与 COVID-19 相关的两种最常见的症状是呼吸困难和疲劳。这种症状的一个可能原因可能是吸气肌无力。
本研究旨在检查 COVID-19 患者从重症监护病房出院（ICUD）到出院（HD）期间的吸气肌性能（IMP），假设在 ICUD 和 HD 时 IMP 会明显降低。
通过 PrO2 设备（PrO2 Health，Smithfield，RI）在 ICUD 和 HD 时检查 IMP，该设备提供最大吸气压力（MIP）、持续 MIP（SMIP）、吸气持续时间（ID）和疲劳指数测试（FIT）。在 ICUD、HD 和 HD 后 1 个月评估患者症状。
纳入 30 例 COVID-19 患者（19 名男性，11 名女性）。平均年龄、BMI 和 ICU 及住院时间分别为 71±11 岁、27.9±6.3kg/m2、9±6 天和 26±16 天。整个队列在 ICUD 与 HD 时的平均 MIP、SMIP、ID 和 FIT 分别为 36±21cm H2O 与 40±20cm H2O、231±157PTU 与 297±182PTU、8.8±4.2s 与 9.5±4.6s、9.0±9.4 与 13.1±12.3，仅 SMIP 和 FIT 在 HD 时显著更高（分别为 p=0.006 和 0.03）。HD 时的 SMIP 与 HD 时的静息呼吸困难显著相关（r=-0.40；p=0.02）。男性的 SMIP 和 FIT 从 ICUD 到 HD 显著增加，但女性的 IMP 没有明显增加。HD 后至少有一种 COVID-19 相关症状，最常见的症状是疲劳、咳嗽和呼吸困难，分别占 47%、40%和 37%的患者。
COVID-19 患者在 ICUD 和 HD 时 IMP 明显降低，且女性的 IMP 无明显增加。与 HD 时的呼吸困难相关的是吸气肌耐力的降低而不是力量的降低。
