Respiratory weakness after mechanical ventilation is associated with one-year mortality - a prospective study

Area of Science:

• Critical Care Medicine
• Respiratory Physiology
• Clinical Outcomes Research

Background:

• Diaphragm dysfunction in mechanically ventilated patients is linked to poor outcomes.
• Maximal inspiratory pressure (MIP) assesses inspiratory muscle function.
• The independent association of respiratory weakness with long-term mortality remains unclear.

Purpose of the Study:

• To determine if low MIP is an independent predictor of one-year mortality in mechanically ventilated patients.
• To investigate the prognostic value of MIP in critical care settings.

Main Methods:

• Prospective observational cohort study of 124 adult ICU patients requiring mechanical ventilation.
• MIP evaluated before extubation; patients grouped by low (≤30 cmH2O) vs. high (>30 cmH2O) MIP.
• One-year mortality analyzed using log-rank test and multivariable Cox regression, adjusting for SAPS 2, BMI, and ventilation duration.

Main Results:

• 54% of patients had low MIP.
• One-year mortality was significantly higher in the low MIP group (31%) compared to the high MIP group (7%).
• Low MIP independently predicted one-year mortality (HR 4.41, p=0.007) after adjustment.

Conclusions:

• Low MIP is frequent in patients on mechanical ventilation.
• Low MIP is an independent risk factor for long-term mortality in ICU patients.
• MIP is a practical bedside assessment tool for prognostication.