Major Muscle Weakness in Patients with Prolonged Mechanical Ventilation and Feasibility of Local Muscle Training Using Electrical Stimulation.

2009 ◽  
Author(s):  
I Vivodtzev ◽  
S Villeneuve ◽  
D Saey ◽  
P Gagnon ◽  
S Provencher ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Electrical Stimulation ◽  
Muscle Weakness ◽  
Prolonged Mechanical Ventilation ◽  
Muscle Training

Muscle weakness in septic patients requiring mechanical ventilation: Protective effect of transcutaneous neuromuscular electrical stimulation

2012 ◽  
Vol 27 (3) ◽  
pp. 319.e1-319.e8 ◽  
Author(s):  
Pablo O. Rodriguez ◽  
Mariano Setten ◽  
Luis P. Maskin ◽  
Ignacio Bonelli ◽  
Silvana Romero Vidomlansky ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Electrical Stimulation ◽  
Protective Effect ◽  
Muscle Weakness ◽  
Neuromuscular Electrical Stimulation

scholarly journals ICU outcomes can be predicted by noninvasive muscle evaluation: a meta-analysis

2020 ◽  
Vol 56 (4) ◽  
pp. 1902482 ◽  
Author(s):  
Clément Medrinal ◽  
Yann Combret ◽  
Roger Hilfiker ◽  
Guillaume Prieur ◽  
Nadine Aroichane ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Muscle Weakness ◽  
Prolonged Mechanical Ventilation ◽  
Library Science ◽  
Cochrane Library ◽  
Evaluation Tool ◽  
Predictive Capacity ◽  
Risk Of Death ◽  
Weaning Failure ◽  
Overall Mortality

BackgroundThe relationship between muscle function in critically ill patients assessed using bedside techniques and clinical outcomes has not been systematically described. We aimed to evaluate the association between muscle weakness assessed by bedside evaluation and mortality or weaning from mechanical ventilation, and the capacity of each evaluation tool to predict outcomes.MethodsFive databases (PubMed, Embase, CINAHL, Cochrane Library, Science Direct) were searched from January 2000 to December 2018. Data were extracted and random effects meta-analyses were performed.Results60 studies were analysed, including 4382 patients. Intensive care unit (ICU)-related muscle weakness was associated with an increase in overall mortality with odds ratios ranging from 1.2 (95% CI 0.60–2.40) to 4.48 (95% CI 1.49–13.42). Transdiaphragmatic twitch pressure had the highest predictive capacity for overall mortality, with a sensitivity of 0.87 (95% CI 0.76–0.93) and a specificity of 0.36 (95% CI 0.27–0.43). The area under the curve (AUC) was 0.74 (95% CI 0.70–0.78). Muscle weakness was associated with an increase in mechanical ventilation weaning failure rate with an odds ratio ranging from 2.64 (95% CI 0.72–9.64) to 19.07 (95% CI 9.35–38.9). Diaphragm thickening fraction had the highest predictive capacity for weaning failure with a sensitivity of 0.76 (95% CI 0.67–0.83) and a specificity of 0.86 (95% CI 0.78–0.92). The AUC was 0.86 (95% CI 0.83–0.89).ConclusionICU-related muscle weakness detected by bedside techniques is a serious issue associated with a high risk of death or prolonged mechanical ventilation. Evaluating diaphragm function should be a clinical priority in the ICU.

scholarly journals Mobility Interventions to Improve Outcomes in Patients Undergoing Prolonged Mechanical Ventilation: A Review of the Literature

2008 ◽  
Vol 10 (1) ◽  
pp. 21-33 ◽  
Author(s):  
JiYeon Choi ◽  
Frederick J. Tasota ◽  
Leslie A. Hoffman
Keyword(s):  
Skeletal Muscle ◽  
Mechanical Ventilation ◽  
Critical Illness ◽  
Muscle Weakness ◽  
Functional Ability ◽  
Prolonged Mechanical Ventilation ◽  
Adverse Outcomes ◽  
Whole Body ◽  
Multicenter Studies ◽  
Skeletal Muscle Weakness

Survivors of critical illness often undergo an extended recovery trajectory. Reduced functional ability is one of several adverse outcomes of prolonged bed rest and mechanical ventilation during critical illness. Skeletal muscle weakness is known to be one of the major phenomena that account for reduced functional ability. Although skeletal muscle weakness is evident after prolonged mechanical ventilation (PMV), few studies have tested the benefits of various types of mobility interventions in this population. The purpose of this article is to review the published research on improving mobility outcomes in patients undergoing PMV. For this review, published studies were retrieved from MEDLINE, PubMed, CINAHL, and the Cochrane Database of Systematic Reviews from January 1990 to July 2007. A total of 10 relevant articles were selected that examined the effect of whole body physical therapy, electrical stimulation (ES), arm exercise, and inspiratory muscle training (IMT). Overall, there is support for the ability of mobility interventions to improve outcomes in patients on PMV but limited evidence of how to best accomplish this goal. Generating more data from multicenter studies and randomized controlled trials is recommended.

scholarly journals Inspiratory Muscle Training in Children: Moderate Loads (60%) Are Safe and Promote an Increase in PIMAX

2020 ◽  
Author(s):  
Milena Siciliano Nascimento ◽  
Cristiane do Prado ◽  
Fernanda Ejzenberg ◽  
Simone Sayuri Kushida ◽  
Amanda Fontes ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Case Reports ◽  
Prolonged Mechanical Ventilation ◽  
Pediatric Population ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
Muscle Training ◽  
Occlusion Time ◽  
Weaning Failure ◽  
Significant Difference

Abstract Background: Weaning failure are complex outcomes as it involves some aspects including weakness of the respiratory muscles. Ventilator-induced diaphragmatic dysfunction has been described as one of the main complications of IMV. Inspiratory muscle training with moderate loads was described in adults as having excellent results in terms of disconnection from the IMV literature. On pediatric population there is still a scarcity of and most of it consists of descriptions of isolated case reports. Methods: This study aims at evaluating whether muscle training using moderate loads will cause an increase in maximal inspiratory pressure (PIMAX) in patients dependent on mechanical ventilation. This is a retrospective study conducted in 2 Pediatric Intensive Care Units from January 2016 to December 2017. All patients who underwent muscle training during the period of the study were included. PIMAX was measured using a manovacuometer. Three measurements were made with an occlusion time of 15 seconds and a recovery interval of 2 minutes between them. Muscle training was performed following the institutional protocol (4 sets of 6 repetitions with a load equivalent to 60% of PIMAX) 1x/day, 6 days a week, excluding the day of the measurement of PIMAX. Results: Six patients undergoing prolonged mechanical ventilation (average time of mechanical ventilation of 9647 hours) who underwent muscle training to disconnect mechanical ventilation were included. The measurements of PIMAX pre-training were compared to weeks 1 to 4. A significant difference on PIMAX was observed after the second week of training (p <0.001). Five patients progressed to IMV disconnection. Conclusion: Our study supports the performance of IMT using moderate loads (60%), with no risk of muscle fatigue as it resulted in a significant increase in PIMAX after 2 weeks of training, with positive outcomes regarding weaning from mechanical ventilation.

scholarly journals Mechanical Ventilation Weaning in Inclusion Body Myositis: Feasibility of Isokinetic Inspiratory Muscle Training as an Adjunct Therapy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Leonardo Cordeiro de Souza ◽  
Josué Felipe Campos ◽  
Leandro Possidente Daher ◽  
Priscila Furtado da Silva ◽  
Alex Ventura ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Inclusion Body ◽  
Inclusion Body Myositis ◽  
Prolonged Mechanical Ventilation ◽  
Inspiratory Muscle ◽  
Inspiratory Muscle Training ◽  
High Rate ◽  
Muscle Training ◽  
Successful Weaning ◽  
Ventilation Weaning

Inclusion body myositis is a rare myopathy associated with a high rate of respiratory complications. This condition usually requires prolonged mechanical ventilation and prolonged intensive care stay. The unsuccessful weaning is mainly related to respiratory muscle weakness that does not promptly respond to immunosuppressive therapy. We are reporting a case of a patient in whom the use of an inspiratory muscle-training program which started after a two-week period of mechanical ventilation was associated with a successful weaning in one week and hospital discharge after 2 subsequent weeks.

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