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Respiratory Musculature Evaluated by Computed Tomography in the Setting of Prolonged Mechanical Ventilation.
Wakefield, Connor J; Jochum, Sarah B; Hejna, Emily E; Peterson, Sarah B; Vines, David L; Shah, Palmi N; Hayden, Dana M; Balk, Robert A.
Afiliación
  • Wakefield CJ; Department of Internal Medicine, Brooke Army Medical Center, San Antonio, Texas. cwakefield6151@gmail.com.
  • Jochum SB; Department of Surgery, Division of Colon and Rectal Surgery, Rush University Medical Center, Chicago, Illinois.
  • Hejna EE; Department of Surgery, Division of Colon and Rectal Surgery, Rush University Medical Center, Chicago, Illinois.
  • Peterson SB; Department of Clinical Nutrition, College of Health Sciences, Rush University Medical Center, Chicago, Illinois.
  • Vines DL; Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, Illinois.
  • Shah PN; Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, Illinois.
  • Hayden DM; Department of Surgery, Division of Colon and Rectal Surgery, Rush University Medical Center, Chicago, Illinois.
  • Balk RA; Department of Internal Medicine, Brooke Army Medical Center, San Antonio, Texas.
Respir Care ; 68(8): 1106-1111, 2023 08.
Article en En | MEDLINE | ID: mdl-37185112
BACKGROUND: Diaphragm atrophy has been observed in subjects who undergo invasive mechanical ventilation. We propose a new method to assess for respiratory muscle (RM) changes in subjects who undergo invasive mechanical ventilation by assessing for changes in respiratory muscles through computed tomography (CT). METHODS: A retrospective case series study was conducted on subjects who underwent invasive mechanical ventilation and received at least 2 chest CT scans during admission. Exclusion criteria included history of chronic mechanical ventilation dependence and neuromuscular disease. Respiratory muscle cross-sectional area (CSA) was measured at the T6 vertebrae. RESULTS: Fourteen subjects were included: mean (± SD) age, BMI, and admission APACHE II scores were 54.0 y (± 14.9), 32.6 kg/m2 (± 10.9), and 23.5 (± 6.0), respectively. Ten (71%) subjects were male. Mean length of time between CT chest scans was 7.5 d (± 3.3). Mean duration of invasive mechanical ventilation was 4.5 d (± 3.4). The percentage change in TM CSA among those who underwent invasive mechanical ventilation was 10.5% (± 6.1). CONCLUSIONS: We demonstrated that serial analysis of respiratory muscle CSA through CT chest scans can be a method to assess for respiratory muscle atrophy in subjects undergoing mechanical ventilation. Future prospective studies involving larger populations are needed to better understand how this method can be used to predict outcomes in mechanically ventilated patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Respiración Artificial / Músculos Respiratorios Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Respir Care Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Respiración Artificial / Músculos Respiratorios Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Respir Care Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos