Handgrip Strength Predicts Difficult Weaning But Not Extubation Failure in Mechanically Ventilated Subjects

Respiratory Care
Guillaume CottereauBenjamin Sztrymf

Abstract

Muscle weakness, defined by the Medical Research Council scale, has been associated with delay in mechanical ventilation weaning. In this study, we evaluated handgrip strength as a prediction tool in weaning outcome. This was a 1-y prospective study in 2 ICUs in 2 university hospitals. Adult patients who were on mechanical ventilation for at least 48 h and eligible for mechanical ventilation weaning were screened for inclusion. Handgrip strength was evaluated using a handheld dynamometer before each spontaneous breathing trial (SBT). Attending physicians were unaware of handgrip strength and decided on extubation according to guidelines. Eighty-four subjects were included (median age 66 [53-79] y, with a median Simplified Acute Physiology Score II of 49 [37-63]). At the first evaluation, median handgrip strength was significantly associated with weaning outcome as defined by international guidelines: simple (20 [12-26] kg), difficult (12 [6-21] kg), or prolonged (6 [3-11] kg) weaning (P = .008). Time to liberation from mechanical ventilation and ICU stay were significantly longer for subjects classified as having muscle weakness according to the handgrip strength-derived definition (P = .02 and P = .03, respectively). In multiv...Continue Reading

Citations

Jun 23, 2018·Physiological Measurement·Jessica Keim-MalpassMatthew T Clark
Jun 23, 2018·The Clinical Respiratory Journal·Aliae A R Mohamed-HusseinWaleed Gamaleldin Saleh
May 6, 2020·The European Respiratory Journal·Clément MedrinalBouchra Lamia
Feb 14, 2019·Arquivos de neuro-psiquiatria·Débora SchmidtSilvia Regina Rios Vieira
Jul 30, 2020·Seminars in Respiratory and Critical Care Medicine·Joan Daniel MartíElena Gimeno-Santos
May 11, 2020·Heart & Lung : the Journal of Critical Care·Narongkorn Saiphoklang, Chatkarin Tepwimonpetkun
Apr 24, 2021·Critical Care : the Official Journal of the Critical Care Forum·Djahid KennoucheJulien Gondin
Oct 4, 2021·Annals of Intensive Care·Guillaume CottereauBenjamin Sztrymf
Oct 22, 2021·PloS One·Narongkorn Saiphoklang, Nattawadee Mokkongphai

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