Paulo Eugênio Silva1, Vinicius Maldaner2, Luciana Vieira3, Karina Livino de Carvalho4, Hedian Gomes5, Priscilla Melo6, Nicolas Babault7, Gerson Cipriano8, Joao Luiz Quagliotti Durigan8. 1. Physical Therapy Division, University Hospital of Brasília, University of Brasilia, Brasília, DF, Brazil; Health Sciences and Technologies PhD Program, University of Brasilia, DF, Brazil; Physical Therapy Division, Hospital de Base do Distrito Federal, Brasilia, DF, Brazil. Electronic address: pauloeugenio.bsb@gmail.com. 2. Physical Therapy Division, Hospital de Base do Distrito Federal, Brasilia, DF, Brazil; Health Science School, Health Science Master Program, Brasilia, DF, Brazil. 3. Health Sciences and Technologies PhD Program, University of Brasilia, DF, Brazil; Clinical Research Center, Hospital de Base do Distrito Federal, Brasilia, DF, Brazil. 4. Rehabilitation Science Master Program, University of Brasilia, Brasilia, DF, Brazil. 5. Physical Therapy Division, Fisioterapia Integrada de Brasília, Brasília, DF, Brazil. 6. Health Sciences and Technologies PhD Program, University of Brasilia, DF, Brazil; Physical Therapy Division, Hospital de Base do Distrito Federal, Brasilia, DF, Brazil. 7. INSERM-U1093 Cognition Action et Plasticité Senorimotrice; UFR STAPS, Université de Bourgogne-Franche-Comté, Dijon, France. 8. Assistant Professor, Physical Therapy Division, University of Brasilia, Brasília, DF, Brazil.
Abstract
PURPOSE: It is unclear whether the muscular changes in mechanically-ventilated traumatic brain injury patients (TBI) are only associated with disuse or additionally to neuromuscular electrophysiological disorders (NED). The correlation between muscle atrophy and NED may affect functional outcomes and rehabilitation programs significantly. MATERIAL AND METHODS: An observational study was performed to investigate the presence of NED and muscle atrophy in TBI patients undergoing mechanical ventilation. NED was diagnosed by the stimulus electrodiagnosis test when chronaxie was ≥1000μs. The muscle structure (thickness and echogenicity) was assessed by B-mode ultrasound. Tibialis anterior (TA), rectus femoris (RF), and biceps brachialis (BB) muscles were analyzed. Patients were followed from the first day of admission in the intensive care unit (ICU) to the fourteenth day. RESULTS: Twenty-two patients were analyzed. An increase of 48% in NED from day 1 to day 14 was detected in TA (p=0.004). All muscles presented a significant decrease in thickness (~18%, p<0.05), but echogenicity increased only in TA (19%), p<0.01 and RF (23%), p<0.01. CONCLUSIONS: Mechanically-ventilated patients with TBI developed NED in addition to changes in muscle structure during their stay in the ICU.
PURPOSE: It is unclear whether the muscular changes in mechanically-ventilated traumatic brain injurypatients (TBI) are only associated with disuse or additionally to neuromuscular electrophysiological disorders (NED). The correlation between muscle atrophy and NED may affect functional outcomes and rehabilitation programs significantly. MATERIAL AND METHODS: An observational study was performed to investigate the presence of NED and muscle atrophy in TBIpatients undergoing mechanical ventilation. NED was diagnosed by the stimulus electrodiagnosis test when chronaxie was ≥1000μs. The muscle structure (thickness and echogenicity) was assessed by B-mode ultrasound. Tibialis anterior (TA), rectus femoris (RF), and biceps brachialis (BB) muscles were analyzed. Patients were followed from the first day of admission in the intensive care unit (ICU) to the fourteenth day. RESULTS: Twenty-two patients were analyzed. An increase of 48% in NED from day 1 to day 14 was detected in TA (p=0.004). All muscles presented a significant decrease in thickness (~18%, p<0.05), but echogenicity increased only in TA (19%), p<0.01 and RF (23%), p<0.01. CONCLUSIONS: Mechanically-ventilated patients with TBI developed NED in addition to changes in muscle structure during their stay in the ICU.
Authors: Joana Castro; Karina Livino de Carvalho; Paulo Eugênio Silva; Emerson Fachin-Martins; Nicolas Babault; Rita de Cássia Marqueti; João Luiz Quagliotti Durigan Journal: PLoS One Date: 2019-06-27 Impact factor: 3.240
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