Músculos respiratórios, músculos esqueléticos e capacidade funcional de pacientes críticos - métodos de avaliação

Abstract

Introduction: Patients on mechanical ventilation (MV) in the ICU have acquired muscle weakness. Therefore, the transition from MV to spontaneous breathing should be initiated as soon as possible, and it is important to establish appropriate weaning strategies. The objective is to compare two methods of measuring maximal inspiratory pressure (MIP) in patients on MV and to correlate with skeletal muscle strength assessed by the handgrip dynamometer and the Medical Research Council (MRC) scale, functional capacity by the Perme (PE) scale and to determine whether grip strength is correlated with MRC and PE at extubation and ICU discharge. Methods: Study conducted in the ICU with patients ≥18 years, after 48 hours of MV, randomized in methods of measurement of MIP: with manometer coupled to the unidirectional valve (MIP-OWV) and MV method (MIP-VM). Results: 32 patients evaluated by MIP-OWV and MIP-VM. There was no significant difference in the MIP methods, and a positive correlation was found between MIP-OWV and MIP-VM (r=0.693, p<0.05). There was a moderate correlation between grip strength and the MRC scale at extubation and discharge, and no correlation was found between grip strength and PE score at extubation or discharge. Conclusion: No significant differences were found in the measurements of MIP-OWV and MIP-VM, the two methods were positively correlated. These measurements did not correlate with skeletal muscle strength and functional capacity. Grip strength correlated with skeletal muscle strength, but not with functional capacity. However, a positive correlation was found between MRC and PE in the discharge of the patients.