探索ICU患者的外周和呼吸道肌肉软弱和功能障碍:来自资源有限环境的见解
Shanita Chhiba1, Susan D Hanekom, Alison R Lupton-Smith
1All authors: Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa.
Critical care explorations
|March 26, 2025
概括
在资源有限的ICU中,重症患者会出现显著的外周和呼吸道肌肉衰弱,即使在短期停留. 肌肉结构通过超声波显示了最小的变化,表明了明显的严重疾病表型.
科学领域:
- 关键护理医学 关键护理医学
- 重症监护室 (ICU) 患者的治疗结果.
- 关键疾病中的肌肉生理学
背景情况:
- 在重症监护室获得的虚弱是重症患者的常见并发症.
- 在资源有限的ICU设置中,关于肌肉结构和力量变化的数据有限.
研究的目的:
- 研究从入院到出院的ICU患者的外周和呼吸道肌肉结构和强度.
- 在资源有限的环境中评估这些变化.
主要方法:
- 在高等学术医院进行前性观察性研究.
- 包括新输入直通管的严重病情的成年人,需要机械通风>48小时.
- 通过超声波评估腹膜和四头肌肌肉结构,并使用MRC-Sum得分,动力计和最大吸气压力 (MIP) 评估肌肉力量.
主要成果:
- 包括45名参与者 (平均年龄34.5岁,73%是男性).
- 截面膜厚度在第三天下降了22%;直腿骨的大小显示微小的变化.
- 在重症监护室获得的弱点在醒来时影响了44%,在出院时降至24%.
- 四肢力量为22.2±5.1N,MIP为29.1%±8.6%,预计在医院出院时.
结论:
- 资源有限的ICU患者在出院时表现出显著的外周和呼吸道肌肉软弱.
- 尽管有弱点,但观察到最小的结构性肌肉变化,这表明潜在的独特的严重疾病表型.
- 需要进一步的研究,以了解在资源有限的环境中这种现象.
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