Neuromuscular electrophysiological disorders and muscle atrophy in mechanically-ventilated traumatic brain injury patients: New insights from a prospective observational study

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 ≥1000mus. 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.
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https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01657030
Contributeur : Caps - Université de Bourgogne <>
Soumis le : mercredi 6 décembre 2017 - 11:50:27
Dernière modification le : vendredi 8 juin 2018 - 14:50:17

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Paulo Eugênio Silva, Vinicius Maldaner, Luciana Vieira, Karina Livino De Carvalho, Hedian Gomes, et al.. Neuromuscular electrophysiological disorders and muscle atrophy in mechanically-ventilated traumatic brain injury patients: New insights from a prospective observational study. Journal of Critical Care, WB Saunders, 2018, 44, pp.87 - 94. 〈http://www.sciencedirect.com/science/article/pii/S0883944117307384?via%3Dihub〉. 〈10.1016/j.jcrc.2017.10.026〉. 〈hal-01657030〉

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