title: [Evolution in muscle strength in critical patients with invasive mechanical ventilation].
abstract: OBJECTIVE
  To assess the evolution of muscle strength in critically ill patients with mechanical ventilation (MV) from withdrawal of sedatives to hospital discharge.
  
  
  METHODS
  A cohort study was conducted in two intensive care units in the Hospital Universitari de Bellvitge from November 2011 to March 2012.
  
  
  METHODS
  Consecutive patients with MV > 72h. Dependent outcome: Muscle strength measured with the Medical Research Council (MRC) scale beginning on the first day the patient was able to answer 3 out of 5 simple orders (day 1), every week, at ICU discharge and at hospital discharge or at day 60 Independent outcomes: factors associated with muscle strength loss, ventilator-free days, ICU length of stay and hospital length of stay. The patients were distributed into two groups (MRC< 48, MRC ≥ 48) after the first measurement.
  
  
  RESULTS
  Thirty-four patients were assessed. Independent outcomes associated with muscle strength weakness were: days with cardiovascular SOFA >2 (P<.001) and days with costicosteroids (P<.001). Initial MRC in MRC<48 group was 38 (27-43), and 52 (50-54) in MRC ≥ 48. The largest muscle strength gain was obtained the first week (31% versus 52%). A MRC < 48 value was associated with more MV days (P<.007) and a longer ICU stay. (P<.003).
  
  
  CONCLUSIONS
  The greatest muscle strength gain after withdrawing of the sedatives was achieved in the first week. Muscle strength loss was associated with a cardiovascular SOFA > 2 and costicosteroids. Patients with a MRC < 48 required more days with MV and a longer ICU stay.
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España; Departamento Enfermería Fundamental y Médico-Quirúrgica, Escuela Universitaria de Enfermería, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España. Electronic address: gviac@ub.edu.
authors.forename: G
authors.initials: G
authors.lastname: Via Clavero
authors.forename: M
authors.initials: M
authors.lastname: Sanjuán Naváis
authors.forename: M
authors.initials: M
authors.lastname: Menéndez Albuixech
authors.forename: L
authors.initials: L
authors.lastname: Corral Ansa
authors.forename: G
authors.initials: G
authors.lastname: Martínez Estalella
authors.forename: A
authors.initials: A
authors.lastname: Díaz-Prieto-Huidobro
mesh_terms: D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D020127:Recovery of Function; D012121:Respiration, Artificial
keywords: Critical illness; Debilidad muscular; Enfermedad crítica; Fuerza muscular; Mechanical ventilation; Muscle strength; Muscle weakness; Ventilación mecánica