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Inspiratory Muscle Training as an Adjunct to the Treatment of Weaning Failure in Critically Ill Patients: A Practical Guide
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Handgrip Strength Predicts Difficult Weaning But Not Extubation Failure in Mechanically Ventilated Subjects.
Guillaume Cottereau1, Martin Dres2, Alexandre Avenel3
1Physiotherapy and Rehabilitation Department, Hôpital Antoine-Béclère, Clamart, France.
Respiratory Care
|March 12, 2015
Summary
Handgrip strength can predict difficult or prolonged mechanical ventilation weaning and intensive care unit (ICU) stay. However, it does not predict extubation outcomes in patients requiring mechanical ventilation.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Neurology
Background:
- Muscle weakness is linked to delayed weaning from mechanical ventilation.
- Handgrip strength is evaluated as a potential predictor of weaning success.
Purpose of the Study:
- To assess the utility of handgrip strength in predicting mechanical ventilation weaning outcomes.
Main Methods:
- Prospective study in 2 university hospital ICUs over 1 year.
- Adult patients on mechanical ventilation for ≥48 hours were included.
- Handgrip strength measured using a handheld dynamometer before spontaneous breathing trials (SBTs).
Main Results:
- Lower handgrip strength correlated with difficult or prolonged weaning (P = .008).
- Muscle weakness identified by handgrip strength was associated with longer mechanical ventilation duration and ICU stay (P = .02 and P = .03).
- COPD history, sex, and initial handgrip strength predicted difficult/prolonged weaning in multivariate analysis.
Conclusions:
- Handgrip strength effectively identifies patients at risk for prolonged mechanical ventilation weaning and extended ICU stays.
- Handgrip strength is not associated with extubation failure risk.
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