Association between hand grip strength with weaning and intensive care outcomes in COPD patients: A pilot study

In COPD, weight loss and muscle wasting contribute significantly to morbidity, disability, and handicap. Dominant-handgrip strength for evaluation of muscle strength has not been tested as a parameter to predict outcome of weaning from mechanical ventilation (MV).

To evaluate the association between handgrip strength and the duration and success of weaning and extubation outcome.

This prospective study included 34 COPD patients requiring MV for at least 48 hours. Recovery from sedation and muscle relaxants was assessed before recruitment. Serial meseaurment of handgrip strength were assessed by trained personnel.

There was a significant negative correlation between baseline hand grip and duration of MV (P = .047, r = -.343). The mean day 5 hand grip was significantly lower in person who died compared to survivors (5.7 ± 5.5 vs 18.2 ± 14.5, P = .044). The mean day 5 hand grip was significantly lower in patients who needed reintubation compared to those in patients who did not need reintubation (2.8 ± 2 vs 17.2 ± 13.9, P = .029). There was no significant difference in the mean baseline, day 2, day 3, day 4 and day 5 hand grip in weaning success compared to those in failure (P > .05).

Handgrip strength may be good predictor for duration of MV, extubation outcome, ICU mortality and prognosis.