![]() Hilfiker 3, Nadine Aroichane 4, Tristan Bonnevie 5, Francis-Edouard Gravier 5, Guillaume Prieur 1, Olivier Contal 6, Bouchra Lamia 7 1Le Havre Hospital, ICU Department. Despite our results, different clinical techniques for quantifying expiratory muscle weakness may provide more beneficial results.įull size table COK-2 Consequences of ICU acquired weakness: a systematic review and meta-analysis Clement Medrinal 1, Yann Combret 2, Roger ![]() mechanical in-exsufflation).Ĭonclusion: In our cohort, MEP was not associated with mechanical ventilation weaning or death. Expiratory muscle weakness was unable to predict critical outcomes when adjusting MEP to the %predicted or lower limit of normal.ĭiscussion: Possible explanation is that contrary to inspiratory muscle weakness, cough inefficacy after weaning from mechanical ventilation could be managed with cough supplementation techniques ( i.e. MEP was statistically able to predict ICU-AW but area under (AUC) receiving operating curves showed weak predictive ability (AUC: 0.66 (95% IC 0.55–0.77 p < 0.01) for a threshold value ≤ 49 cmH 2O. No other outcomes were different between groups. Patients with low MEP presented more ICU-AW compared to normal MEP patients (64% vs. ![]() Inversely, higher body mass index was associated with higher MEP. Patients with low MEP received more catecholamines (p = 0.04) and a higher duration of mechanical ventilation (p = 0.001). Results: Due to the paucity of data reporting threshold value for expiratory muscle weakness, we considered our median value (47 cmH 2O (IQR 44)) as the threshold value for expiratory muscle weakness group (MEP ≤ 47 cmH 2O) and normal expiratory muscle group (MEP > 47 cmH 2O). MEP diagnostic accuracy to predict ICU-AW (ICU acquired weakness), weaning success and sursvival within 30 days were assessed using expiratory muscle strength as absolute values (cmH 2O), as %predicted values and as %lower limit of normal. Maximal expiratory pressure (MEP) measurement was carried out during spontaneous breathing trial using a manometer with an unidirectional valve. Patients and methods: This study is a secondary analysis of our previously described cohort of 124 patients ventilated for at least 24 h assessed for respiratory muscles function. However, few studies reported potential factors leading to expiratory muscle weakness and its importance on weaning success or survival after mechanical ventilation. Several authors stated these muscles importance in cough capacity, contractile efficiency of the diaphragm or reduction of hyperinflation. Rationale: Expiratory muscles has recently been stated as the «neglected component» in mechanically ventilated patient. ![]() Keep yourself alert – maybe, there are no aggressive insects, such as bees, beetles, spiders or butterflies, but humans at their home are nearby you.COK-1 Expiratory muscle weakness quantified by maximal expiratory pressure may be insufficient in predicting critical outcomes in mechanically ventilated patients Yann Combret 1, Guillaume Prieur 1, Francis-Edouard Gravier 2, Tristan Bonnevie 2, Olivier Contal 3, Bouchra Lamia 1, Clement Medrinal 1 1Groupe Hospitalier du Havre, Le Havre, France 2ADIR Association, Rouen, Fs 3Haute Ecole de Santé Vaud, Lausanne, Switzerland Correspondence: Yann Combret Intensive Care 2020, 10 (Suppl 1):COK-1 Do you like animal or insect simulators? Check Cockroach Simulator and help a lonely insect to stay alive in a dangerous human household! Just imagine you are an ordinary house roach – sneaky but nice creature - in the house full of aggressive predators, large fearful monsters - humans! Protect your life from humans’ aggression - it will be an epic battle, we promise!
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