Magnetic twitch assessment of diaphragm and quadriceps weakness in critically ill mechanically ventilated patients.
Magnetic twitch assessment of diaphragm and quadriceps weakness in critically ill mechanically ventilated patients.
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DOI：
10.1016/j.resp.2021.103789
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发表时间：
2022-01
影响因子：
2.3
通讯作者：
Callahan LA
中科院分区：
文献类型：
--
作者：
Supinski GS;Netzel PF;Westgate PM;Schroder EA;Wang L;Callahan LA
重症机械通气（MV）患者会出现严重的肌无力，这具有重大的临床后果。然而，关于下肢无力的严重程度、肌肉力量和厚度之间的精确关系以及MV患者无力的风险因素，仍然存在不确定性。因此，我们使用磁刺激测量了MV患者的膈肌（PdiTw）和四头肌（QuadTw）强度，并将强度与肌肉厚度进行了比较。MV患者的PdiTw和QuadTw均显著降低，PdiTw为正常值的19%，QuadTw为正常值的6%。两块肌肉的强度和厚度之间的相关性很差，当强度严重降低时，厚度通常保持在正常范围内。回归分析显示PdiTw的降低与感染（p=0.006）和年龄（p=0.007）相关。QuadTw与MV持续时间相关性最好（p=0.036）。重症患者的四肢肌肉非常虚弱，其严重程度与横隔膜的虚弱程度相对应。
Critically ill mechanically ventilated (MV) patients develop significant muscle weakness, which has major clinical consequences. There remains uncertainty, however, regarding the severity of leg weakness, the precise relationship between muscle strength and thickness, and the risk factors for weakness in MV patients. We therefore measured both diaphragm (PdiTw) and quadriceps (QuadTw) strength in MV patients using magnetic stimulation and compared strength to muscle thickness. Both PdiTw and QuadTw were profoundly reduced for MV patients, with PdiTw 19% of normal and QuadTw 6% of normal values. There was a poor correlation between strength and thickness for both muscles, with thickness often remaining in the normal range when strength was severely reduced. Regression analysis revealed reductions in PdiTw correlated with presence of infection (p=0.006) and age (p=0.007). QuadTw best correlated with duration of MV (p=0.036). Limb muscles are profoundly weak in critically ill patients, with a severity that mirrors the level of weakness observed in the diaphragm.
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影响因子：
8.8
作者：
Supinski GS;Valentine EN;Netzel PF;Schroder EA;Wang L;Callahan LA
通讯作者：
Callahan LA
DOI：
10.1186/s13054-021-03737-9
发表时间：
2021-08-26
期刊：
Critical care (London, England)
影响因子：
--
作者：
Supinski GS;Netzel PF;Westgate PM;Schroder EA;Wang L;Callahan LA
通讯作者：
Callahan LA
影响因子：
1.2
作者：
Ando, Katsutoshi;Doi, Tokuhide;Kaneko, Norihiro
通讯作者：
Kaneko, Norihiro
影响因子：
8.8
作者：
Callahan LA;Supinski GS
通讯作者：
Supinski GS
DOI：
10.1164/rccm.201602-0367oc
发表时间：
2017-01-01
影响因子：
24.7
作者：
Dres, Martin;Dube, Bruno-Pierre;Demoule, Alexandre
通讯作者：
Demoule, Alexandre