ICU Acquired Weakness, Quadriceps Muscle Atrophy
Conditions
Brief summary
ICU-Aw is highly prevalent (50%) among critically ill patients. Its diagnosis is usually delayed as it requires patients' awakening and collaboration to provide accurate measurement. This study aims to investigate the accuracy of an early ultrasound measurement of quadriceps shortening during neuromuscular electrical stimulation to diagnose future ICU-Aw in critically ill patients.
Interventions
DIAGNOSTIC_TESTEarly ultrasound measurement of quadriceps shortening during neuromuscular electrical stimulation (NMES)
NMES will be applied to the quadriceps muscle to generate muscle contraction. Ultrasound measurement of the quadriceps thickness will be provided during contraction and rest, and the shortening of the quadriceps muscle will be measured. A second measurement using Shear-wave elastography measurement will also be undertaken. The measures will be undertaken at day 1 of neuromuscular blockers liberation (if any) as well as at day 3 and day 7 for the patients that will still be received mechanical ventilation at that time.
Sponsors
Groupe Hospitalier du Havre
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Mechanical ventilation for at least 24 hours
Exclusion criteria
* Decision to withhold life-sustaining treatment * Pregnancy * Degenerative neurological pathology with disabling muscle weakness * Pace Maker * Inability to communicate * Chronic loss of autonomy described by the patient's family * Guardianship
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ICU-Aw diagnosis | In the 24 hours following extubation | Measured with the Medical Research Council score (scored 0 (minimum) to 60 (maximum); with a score \< 48 meaning ICU-acquired weakness) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory muscles strength | In the 30 minutes before extubation (during spontaneous breathing trial) | Maximal Inspiratory Pressure and Maximal Expiratory Pressure |
| Cough capacity | In the 30 minutes before extubation (during spontaneous breathing trial) | Peak Cough Flow |
| Extubation failure/success | Within 48 hours after extubation | Reintubation or death |
Countries
France
Outcome results
None listed