Mechanical Ventilation Complication Clinical Trial
Official title:
Hand Grip Strength and Medical Research Council Scale as Predictors of Weaning Failure and Duration of Mechanical Ventilation.
The handgrip strength (HGS) will be measured with a digital dynamometer. Three measurements
will be taken, whose average of the three measurements will be collected.
Muscle weakness will be diagnosed based on previously published ICU acquired weakness
(ICU-AW) scores (for males <11 kg and females <7 kg).
The overall motor function of the patient will be assessed using the Medical Research Council
(MRC) scale. The maximum score of the scale is 60 points, adding the degree of muscle
strength of all muscle groups tested. If the patient is unable to have one of the limbs
tested, it is assumed that the limb would have the same force as the contralateral limb.
A score of 48 points or less is indicative of muscle weakness. Individuals who scored between
48 and 37 points on the MRC scale are considered to have significant weaknesses; those with
36 points or less are classified as severely weak.
The HGS and the MRC scale will be compared as predictors of weaning duration of mechanical
ventilation
The handgrip strength will be measured with a digital dynamometer. The patient's dominant
hand will be tested, with the patient as seated as possible, with the elbow as close as to
90º. Three measurements will be taken, respecting a minute interval between them, whose
average of the three measurements will be collected.
Muscle weakness will be diagnosed based on previously published weakness scores (for males
<11 kg (kilograms) and females <7 kg) 25. The strength value will be normalized as a relative
value in percent, calculated according to Bohannon et al. based on values of healthy
individuals, considering gender and age. It will also be normalized according to height, due
to the known impact of this anthropometric feature on palmar strength.
The overall motor function of the patient will be assessed using the Medical Research Council
(MRC) 24 scale. The evaluation will consist of the bilateral analysis of six specific
movements (shoulder abduction, elbow flexion, wrist flexion, hip flexion, knee extension,
ankle dorsiflexion) through manual muscle testing, scoring from zero to five points 2 =
movement without the action of gravity, 3 = movement against the action of gravity, 4 = a
slight manual resistance wins, 5 = a great manual resistance wins ). The maximum score of the
scale is 60 points, adding the degree of muscle strength of all muscle groups tested. If the
patient is unable to have one of the limbs tested (for example: amputation) it is assumed
that the limb would have the same force as the contralateral limb.
In order to standardize the position during the application of the scale and to minimize
bias, the position will be adopted in the supine position, with the bed between 45º to 60º
and symmetrical posture. First the patient will be asked to move freely. According to the
result, manual resistance is imposed or the action of gravity is eliminated.
The indicative weakness score is 48 points or less. Individuals who score between 48 and 37
points on the MRC scale are considered to have significant weaknesses; those with 36 points
or less are classified as severely weak.
The handgrip strength and the MRC scale will be compared as predictors of weaning duration of
mechanical ventilation
;
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