Tavares Graziele S, Oliveira Cristino C, Mendes Liliane P S, Velloso Marcelo
Postgraduate Research Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil; Department of Physical Therapy, Hospital Metropolitano Dr. Célio de Castro, Belo Horizonte, Brazil.
Postgraduate Research Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy, and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil; Postgraduate Research Program in Rehabilitation Sciences and Physical Function Performance, Faculty of Physical Therapy, Federal University of Juiz de Fora, Governador Valadares, Brazil.
Heart Lung. 2023 Nov-Dec;62:233-239. doi: 10.1016/j.hrtlng.2023.08.004. Epub 2023 Aug 19.
Critical illness may affect muscle strength and mobility.
To compare muscle strength, mobility, and in intensive care unit (ICU)-acquired weakness (ICUAW) prevalence among individuals with COVID-19 and other critical illnesses; to identify factors associated with muscle strength, mobility, and length of stay in COVID-19; and to determine the Perme Intensive Care Unit Mobility Score (PICUMS) cut-off point for ICUAW.
We included individuals aged ≥18 in ICU who require mechanical ventilation. We excluded those diagnosed with neuromusculoskeletal diseases or who did not understand the study procedures. The Medical Research Council - sum score (MRC-SS) and the PICUMS were applied before ICU and hospital discharge. Analysis of covariance, Quade´s test, and Fisher's exact test compared groups. Partial correlations were analized between the MRC-SS and PICUMS with clinical variables. Regression models identified the predictors of hospital length of stay. The ROC curve verified the PICUMS related to ICUAW. Significance was set as P<.05.
25 individuals were included in the COVID-19 group and 23 in the non-COVID-19 group. No between-groups difference was observed in MRC-SS and PICUMS at discharge from ICU or hospital. The MRC-SS and PICUMS at ICU discharge predicted the length of hospital stay in the COVID-19 group. The PICUMS cut-off related to ICUAW was 18.
Muscle strength, mobility, and ICUAW are similar between COVID-19 and non-COVID-19. However, muscle strength and mobility at ICU discharge are associated with the length of stay during COVID-19. A PICUMS<18 at ICU discharge may indicate impaired physical functioning due to ICUAW.
危重症可能影响肌肉力量和活动能力。
比较新型冠状病毒肺炎(COVID-19)患者与其他危重症患者的肌肉力量、活动能力及重症监护病房(ICU)获得性肌无力(ICUAW)的患病率;确定COVID-19患者中与肌肉力量、活动能力及住院时间相关的因素;并确定ICUAW的Perm重症监护病房活动评分(PICUMS)切点。
纳入ICU中年龄≥18岁且需要机械通气的患者。排除诊断为神经肌肉骨骼疾病或不理解研究程序的患者。在ICU和出院前应用医学研究委员会总评分(MRC-SS)和PICUMS。采用协方差分析、奎德检验和费舍尔精确检验对组间进行比较。分析MRC-SS和PICUMS与临床变量之间的偏相关性。回归模型确定住院时间的预测因素。ROC曲线验证与ICUAW相关的PICUMS。显著性设定为P<0.05。
COVID-19组纳入25例患者,非COVID-19组纳入23例患者。在ICU或医院出院时,两组间MRC-SS和PICUMS无差异。ICU出院时的MRC-SS和PICUMS可预测COVID-19组的住院时间。与ICUAW相关的PICUMS切点为18。
COVID-19患者与非COVID-19患者的肌肉力量、活动能力及ICUAW相似。然而,ICU出院时的肌肉力量和活动能力与COVID-19期间的住院时间相关。ICU出院时PICUMS<18可能表明因ICUAW导致身体功能受损。