期刊
JOURNAL OF CRITICAL CARE
卷 44, 期 -, 页码 87-94出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jcrc.2017.10.026
关键词
Chronaxie; Critical illness polyneuropathy; Intensive care unit-acquired weakness; Neuromuscular disorder; Neuromuscular electrical stimulation; Rehabilitation
资金
- Fundacao de Amparo a Pesquisa do Distrito Federal (FAPDF) [193.000.862/2014]
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [447529/2014-5, 310359/2014-7]
- CAPES (Programa Ciencias sem Fronteiras, Pesquisador Visitante Especial) [88881.068106/2014-01]
Purpose: It is unclear whether the muscular changes in mechanically-ventilated traumatic brain injury patients (TBI) are only associated with disuse or additionally to neuromuscular electrophysiological disorders (NED). The correlation between muscle atrophy and NED may affect functional outcomes and rehabilitation programs significantly. Material and methods: An observational study was performed to investigate the presence of NED and muscle atrophy in TBI patients undergoing mechanical ventilation. NED was diagnosed by the stimulus electrodiagnosis test when chronaxie was >= 1000 mu s. The muscle structure (thickness and echogenicity) was assessed by B-mode ultrasound. Tibialis anterior (TA), rectus femoris (RF), and biceps brachialis (BB) muscles were analyzed. Patients were followed from the first day of admission in the intensive care unit (ICU) to the fourteenth day. Results: Twenty-two patients were analyzed. An increase of 48% in NED from day 1 to day 14 was detected in TA (p = 0.004). All muscles presented a significant decrease in thickness (similar to 18%, p < 0.05), but echogenicity increased only in TA (19%), p < 0.01 and RF (23%), p < 0.01. Conclusions: Mechanically-ventilated patients with TBI developed NED in addition to changes inmuscle structure during their stay in the ICU. (C) 2017 Elsevier Inc. All rights reserved.
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