Predictors of Prognosis in Patients With Critical Illness.

Summary

Recently, intensive care unit acquired weakness (ICUAW) has become a hotspot issue in the patients with critical illness. The symptoms of ICUAW, including sensory impairment and muscle atrophy, may lead to poor quality of life even though the patients discharged from the ICU for a long time. Therefore, an ounce of prevention is worth a pound of cure. At the same time, early evaluation is necessary to keep critically ill patients away from ICUAW. Medical Research Council (MRC) scale is the most common approach for diagnosis clinically. Regarding the interrater variation of MRC, handgrip strength (HGS) has been thought to be a simple and accurate alternative. However, HGS does not belong to antigravity or respiratory muscle which are the first to be affected by immobilization. It is still unknown whether HGS can represent the general muscle condition in ICU or not.

Additionally, previous studies have proved that patients with critical illness in the ICU would have better prognosis and less complications, if they undergo physical therapy as soon as possible. In addition to early ventilator weaning and reduced mortality rate, physical therapy could enhance quality of life (QoL) after patient discharges from hospital. However, early mobility in the ICU mainly emphasizes cardiopulmonary patients due to the traditional concept in Taiwan. Hence, the duration of mechanical ventilation in the critical patients will affect the timing to receive physical therapy, even impact the improvement of QoL.

Because of these reasons, this study will investigate the relationship between HGS and muscle mass among patients with critical illness and find the predictors of the short-term and long-term goals in the ICU, including ventilator weaning and QoL after hospital discharge.

Conditions

• ICU Acquired Weakness
• Weaning Failure
• Quality of Life

Interventions

OTHER

Regular care in the surgery intensive care unit

Part 1: Two arms(muscle thickness observation): 1. Inspiratory muscles: diaphragm 2. Anti-gravity muscles: rectus femoris and the vastus intermedius Part 2: Predictors of short-term and long-term goals in the ICU 1. Short-term goal: successful ventilator weaning in the ICU- pass weaning profile without re-intubation in the hospital 2. Long-term goal- Quality of life after hospital discharge: SF-36 (Taiwan version)

Sponsors & Collaborators

• National Yang Ming Chiao Tung University

  collaborator OTHER

• Ministry of Science and Technology of the People´s Republic of China

  collaborator OTHER_GOV

• Taoyuan General Hospital

  lead OTHER_GOV

Principal Investigators

• Huan-Jui Yeh · Department of Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2020-01-01

Primary Completion

2021-07-13

Completion

2021-07-13

Countries

• Taiwan

Study Locations