Predictive factors and clinical impact of ICU-acquired weakness on functional disability in mechanically ventilated patients with COVID-19.
Heart Lung
; 60: 139-145, 2023.
Artigo
em Inglês
| MEDLINE | ID: covidwho-2287388
ABSTRACT
BACKGROUND:
Patients with critical COVID-19 often require invasive mechanical ventilation (IMV) and admission to the intensive care unit (ICU), resulting in a higher incidence of ICU-acquired weakness (ICU-AW) and functional decline.OBJECTIVE:
This study aimed to examine the causes of ICU-AW and functional outcomes in critically ill patients with COVID-19 who required IMV.METHODS:
This prospective, single-center, observational study included COVID-19 patients who required IMV for ≥48 h in the ICU between July 2020 and July 2021. ICU-AW was defined as a Medical Research Council sum score <48 points. The primary outcome was functional independence during hospitalization, defined as an ICU mobility score ≥9 points.RESULTS:
A total of 157 patients (age 68 [59-73] years, men 72.6%) were divided into two groups (ICU-AW group; n = 80 versus non-ICU-AW; n = 77). Older age (adjusted odds ratio [95% confidence interval] 1.05 [1.01-1.11], p = 0.036), administration of neuromuscular blocking agents (7.79 [2.87-23.3], p < 0.001), pulse steroid therapy (3.78 [1.49-10.1], p = 0.006), and sepsis (7.79 [2.87-24.0], p < 0.001) were significantly associated with ICU-AW development. In addition, patients with ICU-AW had significantly longer time to functional independence than those without ICU-AW (41 [30-54] vs 19 [17-23] days, p < 0.001). The development of ICU-AW was associated with delayed time to functional independence (adjusted hazard ratio 6.08; 95% CI 3.05-12.1; p < 0.001).CONCLUSIONS:
Approximately half of the patients with COVID-19 requiring IMV developed ICU-AW, which was associated with delayed functional independence during hospitalization.Palavras-chave
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
COVID-19
Tipo de estudo:
Estudo de coorte
/
Estudo experimental
/
Estudo observacional
/
Estudo prognóstico
/
Ensaios controlados aleatorizados
Limite:
Idoso
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Heart Lung
Ano de publicação:
2023
Tipo de documento:
Artigo
País de afiliação:
J.hrtlng.2023.03.008
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