Associação da espessura do quadríceps com a área de secção transversa do reto femoral, força muscular e velocidade da marcha de pacientes críticos

Abstract

ICU patients are prone to morphological, biochemical and structural changes in the muscles, which may lead to decreased strength and hypotrophy. After discharge from the unit, the development of muscle weakness manifests disabilities that may last for up to two years, impacting the physical function of these patients. The aim of this study was to verify whether there is a relationship between quadriceps muscle thickness (EMQ), cross-sectional area (AST), peripheral muscle strength (PFF) and gait speed of critically ill patients. This is a cross-sectional study conducted at the adult intensive care unit (ICU) of a university hospital. Patient assessments were by collecting clinical records from the patient assessment form. In the first 24 hours of mechanical ventilation (MV), the EMQ and AST were evaluated from femoral quadriceps ultrasound images. In the ICU awakening, the MPF was evaluated by the Medical Research Council (MRC) manual muscle strength score, and finally, at hospital discharge, the gait speed was evaluated by the gait speed test. 6 meters (TVM6). In the statistical analysis, the correlation between the EMQ and the other variables was verified by Pearson's correlation coefficient. A regression analysis was performed to investigate the linear relationship between femoral EMQ and femoral AST, FMP, and gait speed variables. The adopted significance level was 5% (p <0.05). Twenty-eight patients were eligible (46 ± 18 years, 20 males). The EMQ showed a strong positive correlation with AST (r = 0.708; p <0.0001) and moderate positive correlation with gait speed (r = 0.627; p = 0.003). However, there was no correlation between EMQ and PFM (r = 0.332; p = 0.084) at hospital discharge. Through multiple linear regression, we observed that rectal femoral AST was the independent predictor factor (p = 0.003) of the EMQ. The present study showed a correlation between EMQ and AST, reinforcing the importance of early recognition of muscle changes in ICU patients. TVM6 may be able to track patients at risk of worse physical and functional outcomes, even in a hospital setting, and may be useful for their prognosis.