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Maximum inspiratory pressure, a surrogate parameter for the assessment of ICU-acquired weakness.

Tzanis G, Vasileiadis I, Zervakis D, Karatzanos E, Dimopoulos S, Pitsolis T, Tripodaki E, Gerovasili V, Routsi C, Nanas S - BMC Anesthesiol (2011)

Bottom Line: A significant correlation was found between MIP and MRC (r = 0.68, p < 0.001).Patients that developed ICU-AW (MRC<48) had a longer weaning period compared to non ICU-AW patients (12 ± 14 versus 2 ± 3 days, p < 0.01).Patients with MIP below the cut-off point of 36 cmH2O had a significant greater weaning period (10 ± 14 versus 3 ± 3 days, p = 0.004) also shown by Kaplan-Meier analysis (log-rank:8.2;p = 0.004).

View Article: PubMed Central - HTML - PubMed

Affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodestrian University of Athens, Athens, Greece. a-icu@med.uoa.gr.

ABSTRACT

Background: Physical examination has been advocated as a primary determinant of ICU-acquired weakness (ICU-AW). The purpose of the study is to investigate ICU-AW development by using Maximum Inspiratory Pressure (MIP) as a surrogate parameter of the standardized method to evaluate patients' peripheral muscle strength.

Methods: Seventy-four patients were recruited in the study and prospectively evaluated in a multidisciplinary university ICU towards the appearance of ICU-AW. APACHE II admission score was 16 ± 6 and ICU stay 26 ± 18 days. ICU-AW was diagnosed with the Medical Research Council (MRC) scale for the clinical evaluation of muscle strength. MIP was measured using the unidirectional valve method, independently of the patients' ability to cooperate.

Results: A significant correlation was found between MIP and MRC (r = 0.68, p < 0.001). Patients that developed ICU-AW (MRC<48) had a longer weaning period compared to non ICU-AW patients (12 ± 14 versus 2 ± 3 days, p < 0.01). A cut-off point of 36 cmH2O for MIP was defined by ROC curve analysis for ICU-AW diagnosis (88% sensitivity,76% specificity). Patients with MIP below the cut-off point of 36 cmH2O had a significant greater weaning period (10 ± 14 versus 3 ± 3 days, p = 0.004) also shown by Kaplan-Meier analysis (log-rank:8.2;p = 0.004).

Conclusions: MIP estimated using the unidirectional valve method may be a potential surrogate parameter for the assessment of muscle strength compromise, useful for the early detection of ICU-AW.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier curves of the probability of remaining under mechanical ventilation (MV) after the onset of weaning according to maximum inspiratory pressure (MIP < or ≥ 36 cmH2O).
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Figure 3: Kaplan-Meier curves of the probability of remaining under mechanical ventilation (MV) after the onset of weaning according to maximum inspiratory pressure (MIP < or ≥ 36 cmH2O).

Mentions: Similarly, patients with MIP < 36 cmH2O had a greater daily probability of remaining under mechanical ventilation (MV) after the onset of weaning compared with those patients with MIP ≥ 36 cmH2O (log-rank:8.2; p = 0.004, Figure 3).


Maximum inspiratory pressure, a surrogate parameter for the assessment of ICU-acquired weakness.

Tzanis G, Vasileiadis I, Zervakis D, Karatzanos E, Dimopoulos S, Pitsolis T, Tripodaki E, Gerovasili V, Routsi C, Nanas S - BMC Anesthesiol (2011)

Kaplan-Meier curves of the probability of remaining under mechanical ventilation (MV) after the onset of weaning according to maximum inspiratory pressure (MIP < or ≥ 36 cmH2O).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3141732&req=5

Figure 3: Kaplan-Meier curves of the probability of remaining under mechanical ventilation (MV) after the onset of weaning according to maximum inspiratory pressure (MIP < or ≥ 36 cmH2O).
Mentions: Similarly, patients with MIP < 36 cmH2O had a greater daily probability of remaining under mechanical ventilation (MV) after the onset of weaning compared with those patients with MIP ≥ 36 cmH2O (log-rank:8.2; p = 0.004, Figure 3).

Bottom Line: A significant correlation was found between MIP and MRC (r = 0.68, p < 0.001).Patients that developed ICU-AW (MRC<48) had a longer weaning period compared to non ICU-AW patients (12 ± 14 versus 2 ± 3 days, p < 0.01).Patients with MIP below the cut-off point of 36 cmH2O had a significant greater weaning period (10 ± 14 versus 3 ± 3 days, p = 0.004) also shown by Kaplan-Meier analysis (log-rank:8.2;p = 0.004).

View Article: PubMed Central - HTML - PubMed

Affiliation: First Critical Care Department, Evangelismos Hospital, National and Kapodestrian University of Athens, Athens, Greece. a-icu@med.uoa.gr.

ABSTRACT

Background: Physical examination has been advocated as a primary determinant of ICU-acquired weakness (ICU-AW). The purpose of the study is to investigate ICU-AW development by using Maximum Inspiratory Pressure (MIP) as a surrogate parameter of the standardized method to evaluate patients' peripheral muscle strength.

Methods: Seventy-four patients were recruited in the study and prospectively evaluated in a multidisciplinary university ICU towards the appearance of ICU-AW. APACHE II admission score was 16 ± 6 and ICU stay 26 ± 18 days. ICU-AW was diagnosed with the Medical Research Council (MRC) scale for the clinical evaluation of muscle strength. MIP was measured using the unidirectional valve method, independently of the patients' ability to cooperate.

Results: A significant correlation was found between MIP and MRC (r = 0.68, p < 0.001). Patients that developed ICU-AW (MRC<48) had a longer weaning period compared to non ICU-AW patients (12 ± 14 versus 2 ± 3 days, p < 0.01). A cut-off point of 36 cmH2O for MIP was defined by ROC curve analysis for ICU-AW diagnosis (88% sensitivity,76% specificity). Patients with MIP below the cut-off point of 36 cmH2O had a significant greater weaning period (10 ± 14 versus 3 ± 3 days, p = 0.004) also shown by Kaplan-Meier analysis (log-rank:8.2;p = 0.004).

Conclusions: MIP estimated using the unidirectional valve method may be a potential surrogate parameter for the assessment of muscle strength compromise, useful for the early detection of ICU-AW.

No MeSH data available.


Related in: MedlinePlus