Use of non-invasive-stimulated muscle force assessment in long-term critically ill patients: a future standard in the intensive care unit?

被引:16
作者
Ginz, H. F. [1 ,2 ]
Iaizzo, P. A. [3 ,4 ,5 ]
Urwyler, Albert [2 ]
Pargger, H. [6 ]
机构
[1] Cty Hosp, Div Operat Crit Care, Dept Anaesthesia, D-79539 Lorrach, Germany
[2] Univ Basel Hosp, Dept Anaesthesia & Res, Basel, Switzerland
[3] Univ Minnesota, Dept Surg, Minneapolis, MN USA
[4] Univ Minnesota, Dept Anesthesiol & Integrat Biol, Minneapolis, MN USA
[5] Univ Minnesota, Dept Physiol, Minneapolis, MN USA
[6] Univ Basel Hosp, Div Operat Crit Care, Dept Anaesthesia, Basel, Switzerland
关键词
muscle; skeletal; torque; isometric contraction; immobilization; intensive care units; critical illness;
D O I
10.1111/j.1399-6576.2007.01427.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: This study's main purpose was to test the feasibility of employing a non-invasive-stimulated muscle force assessment approach in long-term critically ill patients. Methods: A case series was performed over a 4-year period in the intensive care unit (ICU). Of the 25 patients initially recruited, eight patients required long-time mechanical ventilation for a median of 3.8 weeks (range 2-10 weeks) and were immobilized for 5 weeks (range 2-10 weeks). With a previously tested non-invasive measuring device, we weekly assessed peak torques and rates of force development and relaxation of patients' ankle dorsiflexor contractile responses, induced via peroneal nerve stimulation. Subsequently, we derived each patient's time course of observed progressive weakness and/or recovery. Results: During their critical illnesses, seven out of eight patients elicited significant decreases in measured peak torques. In survivors (n = 6) during their recovery periods, torques gradually recovered. In the two patients who died, their strengths decreased continuously until death. The rate of force development data elicited similar trends as peak torque responses, whereas relative relaxation rates differed more widely between individuals. Conclusion: This approach of non-invasive-stimulated muscle force assessment can be used in long-term critically ill patients and may eventually become a standard in the intensive care unit, e.g. for assessing recovery. This method is easy to employ, reproducible, provides important phenotypic quantification of skeletal muscle contractile function, and can be used for long-term outcomes assessment.
引用
收藏
页码:20 / 27
页数:8
相关论文
共 27 条
[1]   Critical illness polyneuromyopathy: the electrophysiological components of a complex entity [J].
Bednarik, J ;
Lukas, Z ;
Vondracek, P .
INTENSIVE CARE MEDICINE, 2003, 29 (09) :1505-1514
[2]   POLYNEUROPATHY IN CRITICALLY ILL PATIENTS [J].
BOLTON, CF ;
GILBERT, JJ ;
HAHN, AF ;
SIBBALD, WJ .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1984, 47 (11) :1223-1231
[3]   AMERICAN-COLLEGE OF CHEST PHYSICIANS SOCIETY OF CRITICAL CARE MEDICINE CONSENSUS CONFERENCE - DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].
BONE, RC ;
BALK, RA ;
CERRA, FB ;
DELLINGER, RP ;
FEIN, AM ;
KNAUS, WA ;
SCHEIN, RMH ;
SIBBALD, WJ ;
ABRAMS, JH ;
BERNARD, GR ;
BIONDI, JW ;
CALVIN, JE ;
DEMLING, R ;
FAHEY, PJ ;
FISHER, CJ ;
FRANKLIN, C ;
GORELICK, KJ ;
KELLEY, MA ;
MAKI, DG ;
MARSHALL, JC ;
MERRILL, WW ;
PRIBBLE, JP ;
RACKOW, EC ;
RODELL, TC ;
SHEAGREN, JN ;
SILVER, M ;
SPRUNG, CL ;
STRAUBE, RC ;
TOBIN, MJ ;
TRENHOLME, GM ;
WAGNER, DP ;
WEBB, CD ;
WHERRY, JC ;
WIEDEMANN, HP ;
WORTEL, CH .
CRITICAL CARE MEDICINE, 1992, 20 (06) :864-874
[4]   An improved method for muscle force neuromuscular disease assessment [J].
Brass, TJ ;
Loushin, MKH ;
Day, JW ;
Iaizzo, PA .
JOURNAL OF MEDICAL ENGINEERING & TECHNOLOGY, 1996, 20 (02) :67-74
[5]   Patterns of neurophysiological abnormality in prolonged critical illness [J].
Coakley, JH ;
Nagendran, K ;
Yarwood, GD ;
Honavar, M ;
Hinds, CJ .
INTENSIVE CARE MEDICINE, 1998, 24 (08) :801-807
[6]   Force assessment in periodic paralysis after electrical muscle stimulation [J].
Day, JW ;
Sakamoto, C ;
Parry, GJ ;
Lehmann-Horn, F ;
Iaizzo, PA .
MAYO CLINIC PROCEEDINGS, 2002, 77 (03) :232-240
[7]   Paresis acquired in the intensive care unit -: A prospective multicenter study [J].
De Jonghe, B ;
Sharshar, T ;
Lefaucheur, JP ;
Authier, FJ ;
Durand-Zaleski, I ;
Boussarsar, M ;
Cerf, C ;
Renaud, E ;
Mesrati, F ;
Carlet, J ;
Raphaël, JC ;
Outin, H ;
Bastuji-Garin, S .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (22) :2859-2867
[8]   Impaired neuromuscular transmission after recovery of the train-of-four ratio [J].
Eikermann, M. ;
Gerwig, M. ;
Hasselmann, C. ;
Fiedler, G. ;
Peters, J. .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 2007, 51 (02) :226-234
[9]   Muscle force and fatigue in patients with sepsis and multiorgan failure [J].
Eikermann, M ;
Koch, G ;
Gerwig, M ;
Ochterbeck, C ;
Beiderlinden, M ;
Koeppen, S ;
Neuhäuser, M ;
Peters, J .
INTENSIVE CARE MEDICINE, 2006, 32 (02) :251-259
[10]   Effect of three anaesthetic techniques on isometric skeletal muscle strength [J].
Ginz, HF ;
Zorzato, F ;
Iaizzo, PA ;
Urwyler, A .
BRITISH JOURNAL OF ANAESTHESIA, 2004, 92 (03) :367-372