Admission status of respiratory, peripheral muscle strengths deficits and functionality in non-ventilated patients under intensive care

Introduction: Upon admission into ICU service not requiring mechanical ventilation, patients are usually considered less serious by the health care staff, which may conceal physical deficits at ICU admission which may worsen due reduced mobility during their stay. Aim: To evaluate respiratory and peripheral muscle strengths and functionality of critically ill non-ventilated patients admitted to the ICU within 48 hours. Methods: An observational study. In 82 patients (47 men), the following parameters were analysed: age, gender, SAPS III, respiratory muscle strength (MIP and MEP), peripheral muscle strength by MRC score, hand grip strength (HGS) and functionality by the functional independence measure scale (FIM), and the scored Physical Function in Intensive Care Test (PFIT-s). Results: The mean age was 57.8±19.54 years and SAPSIII was 44.1±12.6 points. Regarding the status of respiratory muscle strength, values of MIP and MEP below normal occurred in 85.7% and 80% in women and 70.2% and 72.3% in men, respectively. The MRC score was normal in all participants, but for HGS (based on the reference values by Shlussel, MM. et al . Clin Nutri. 2008), 58.5% of the participants presented a reduction; of these, 51.4% were women and 63.8% men. Regarding functionality, the median for FIM was 58 (44-71) points, representing 75.3% of the maximum score, while PFIT-s had a median of 10 (8-11) points, representing 83.3% of the maximum score. Conclusion: In a short stay in an ICU, it is possible to identify already committed changes in either respiratory and peripheral muscle strengths that may compromise functionality evaluated in the first 48 hours of admission.