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Raurell-Torredà, M.; Gallart, E.; Velasco-Sanz, T.R.; Blazquez-Martínez, E.; Contreras Rodríguez, Antonia María; Cimiano, Ester Oreña; Guerrero, Alvaro Ortega; del Aguila, Martínez; Monsalve, Virginia Rodríguez; Cano Herrera, Carlos Leonardo; de la Cuesta, DeliaMaría González; Pardo Artero, María Inmaculada; Laseca, Marta Palacios; Cabello Casao, Ana Isabel; de Vera Bellostas, María BelénVicente; Martínez, Carmen Pérez; González, SheilaEscuder; Cisneros, Amelia Lezcano; Suárez, Roberto Riaño; Cerviño, Begoña Sánchez; García, Miriam González; Tavio, Antonio Linares; Cosío, Lourdes Gómez; Pérez, Ángela Suárez; Rebollo, Sonia Crespo; García, Julián García; López, José Gómez; Mazo, Patricia García; Torre, Eduardo Siguero; Díez, Isabel Muñoz; Vivó, Gemma Marín; Esteve, Montserrat Aran; Rodríguez, Maribel Mirabete; Méndez, Albert Mariné; Sancho, Joan Rosselló; Lamas, Valeria Zafra; Bueno Luna, Angel Lucas; Brianso, Cristina Lerma; García, Rubén Gómez; López, Marta Sabaté; Escrihuela, Roser Roca; Albà, Gemma Torrents; Flores, Vanesa Garcia; Galmés, Joan Melis; Moral, Sandra Belmonte; Pellicer, Montserrat Grau; Eizmendi, Aintzane Ruiz; Moll, Carme Garriga; Guardia, Sergio Cordovilla; Méndez, Susana Sánchez; Álvarez, Mauricio Díaz; Cordo Isorna, José Ramón; Penín, Ángeles Estébez; Díaz, Noelia Regueiro; Carrasco Rodríguez-Rey, Luis Fernando; del Rosario Hernández García, María; González, Saúl García; Sánchez, María del Mar Sánchez; Franco, Carmen Cruzado; Rivera, Beatriz Martín; de la Ventana, Ana Belén Sánchez; Bravo Arcas, Maria Luisa; Lavela, Josefa Escobar; del Pilar Domingo Moreno, María; Nuevo, María Acevedo; Suárez, Alejandro Barrios; Zarza Bejarano, Francisco Javier; Rubio, Virginia Toribio; Chicharro, Patricia Martínez; Martínez, Alexandra Pascual; García, Verónica Ocaña; Burgos, Gema Lendínez; Godino Olivares, María Teresa; José Rodríguez Mondéjar, Juan; Ruiz Martínez, María Vanessa; Celdrán, Daniel Linares; Molina, Antonio Ros; Sánchez, Javier Sáez; Hernández García, María Belén; Méndez, Raquel Navarro; García, Sebastián Gil; Santano, Raquel Aguirre; Díez, Ma Rosario García; Cilla, Laura Aparicio; López, Ane Arrasate; Morán, Ángela Romero; Melgoso, Rosa Paños; Llopis, Beatriz Martínez; Vayá Albelda, María Josefa; Carbonell, Javier Inat; Senent, M.Rosario Alcayne; García, Fátima Giménez; Martínez, María Pastor; Talavera, Dunia Valera; Rovira, María José Segrera; Pozuelo, Maricruz Espí; Aspas, Beatriz Garijo; del Rosario Asensio García, María; Sánchez Muñoz, José Ramón; Mateu, Ramón López
Australian critical care, 09/2021, Letnik: 34, Številka: 5Journal Article
Intensive care unit–acquired muscle weakness (ICUAW) has an incidence of 40–46%. Early mobilisation is known to be a protective factor. The aim of the study was to identify the incidence of ICUAW in Spain and to evaluate variables likely to contribute to the development of ICUAW. A 4-month, prospective observational multicentre cohort study was conducted on patients receiving invasive mechanical ventilation for at least 48 h. Data were collected from ICU day 3 until ICU discharge. The primary outcome was presence of ICUAW (diagnosed using the Medical Research Council MRC scale). The secondary outcome was nurse–patient ratio, physiotherapist availability, analgesia, sedation and delirium management, glycaemic control, and daily level of mobility during the ICU stay as per the ICU Mobility Scale. A logistic regression model was constructed based exclusively on days 3–5 of the ICU stay. The data of 642 patients were analysed from 80 ICUs, accounting for 35% of all ICUs in Spain. The incidence of ICUAW was 58% (275 of 474 patients; 95% confidence interval CI 53–62). The predictors for ICUAW were older age (odds ratio OR = 1.01; 95% CI 1.00–1.03) and more days with renal replacement therapy (OR = 1.01; 95% CI 1.00–1.02). The protective factors for ICUAW were male gender (OR = 0.58; 95% CI 0.38–0.89), higher Barthel Index (showing prehospital functional independence) (OR = 0.97; 95% CI 0.95–0.99), more days of being awake and cooperative (defined by a feasible MRC assessment) (OR = 0.98; 95% CI 0.97–0.99), presence of delirium (OR = 0.98; 95% CI 0.97–0.99), and more days with active mobilisation (ICU Mobility Scale ≥ 4) (OR = 0.98; 95% CI 0.97–0.99). The risk factors for ICUAW were functional dependence before admission, female gender, older age, and more days on renal replacement therapy. The protective factors for ICUAW were feasibility of MRC assessment, the presence of delirium, and being actively mobilised during the first 5 days in the ICU.
