Inspiratory muscle strength and function in mechanically ventilated COVID-19 survivors 3 and 6 months after intensive care unit discharge
Background Knowledge regarding the long-term impact of invasive mechanical ventilation on the inspiratory muscles and functional outcomes in COVID-19 survivors is limited. Methods In this single-centre prospective cohort study, we evaluated invasively ventilated patients with COVID-19 pneumonia 3 an...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2023-01-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/9/1/00329-2022.full |
| _version_ | 1797809453176717312 |
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| author | Maria Natividad Núñez-Seisdedos David Valcárcel-Linares María Teresa Gómez-González Irene Lázaro-Navas Luís López-González Daniel Pecos-Martín Isabel Rodríguez-Costa |
| author_facet | Maria Natividad Núñez-Seisdedos David Valcárcel-Linares María Teresa Gómez-González Irene Lázaro-Navas Luís López-González Daniel Pecos-Martín Isabel Rodríguez-Costa |
| author_sort | Maria Natividad Núñez-Seisdedos |
| collection | DOAJ |
| description | Background
Knowledge regarding the long-term impact of invasive mechanical ventilation on the inspiratory muscles and functional outcomes in COVID-19 survivors is limited.
Methods
In this single-centre prospective cohort study, we evaluated invasively ventilated patients with COVID-19 pneumonia 3 and 6 months post-intensive care unit (ICU) discharge. Outcomes included: maximal inspiratory pressure (MIP), ultrasound parameters for diaphragm function, 6-min walk distance (6MWD), dyspnoea and quality of life. We evaluated associations between MIP and duration of mechanical ventilation with follow-up outcomes.
Results
50 COVID-19 survivors discharged from ICU between 15 October 2020 and 1 April 2021 were enrolled. Overall, survivors showed a recovery trajectory over time. However, impaired MIP remained in 24 (48%) and 12 (24%) at 3 and 6 months, respectively. Diaphragm dysfunction was not observed. At 3 months, 23 (46%) had impaired functional capacity versus 10 (20%) at 6 months. Dyspnoea persisted in 44 (88%) patients at 3 months and 38 (76%) at 6 months. Quality of life was slightly decreased at 3 months with further improvements at 6 months. MIP was correlated to 6MWD, 6MWD % predicted, dyspnoea across follow-up, and quality of life at 3 months. The duration of invasive ventilation was correlated with 6MWD and 6MWD % predicted.
Conclusion
In invasively ventilated COVID-19 survivors, inspiratory muscle strength impairments persisted 6 months after ICU discharge, while maintaining normal diaphragm function. Decreased functional capacity, dyspnoea and slightly reduced health status were observed. Early screening of survivors is of utmost importance to identify those with impairments and at risk of delayed or incomplete recovery. |
| first_indexed | 2024-03-13T06:53:02Z |
| format | Article |
| id | doaj.art-b35bab6e88f64da0ba991852f1fc1585 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-13T06:53:02Z |
| publishDate | 2023-01-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-b35bab6e88f64da0ba991852f1fc15852023-06-07T13:30:43ZengEuropean Respiratory SocietyERJ Open Research2312-05412023-01-019110.1183/23120541.00329-202200329-2022Inspiratory muscle strength and function in mechanically ventilated COVID-19 survivors 3 and 6 months after intensive care unit dischargeMaria Natividad Núñez-Seisdedos0David Valcárcel-Linares1María Teresa Gómez-González2Irene Lázaro-Navas3Luís López-González4Daniel Pecos-Martín5Isabel Rodríguez-Costa6 Physiotherapy Department, Ramón y Cajal University Hospital, Madrid, Spain Physiotherapy Department, Ramón y Cajal University Hospital, Madrid, Spain Physiotherapy Department, Ramón y Cajal University Hospital, Madrid, Spain Physiotherapy Department, Ramón y Cajal University Hospital, Madrid, Spain Physiotherapy Department, Ramón y Cajal University Hospital, Madrid, Spain Department of Physiotherapy, University of Alcalá, Madrid, Spain Department of Physiotherapy, University of Alcalá, Madrid, Spain Background Knowledge regarding the long-term impact of invasive mechanical ventilation on the inspiratory muscles and functional outcomes in COVID-19 survivors is limited. Methods In this single-centre prospective cohort study, we evaluated invasively ventilated patients with COVID-19 pneumonia 3 and 6 months post-intensive care unit (ICU) discharge. Outcomes included: maximal inspiratory pressure (MIP), ultrasound parameters for diaphragm function, 6-min walk distance (6MWD), dyspnoea and quality of life. We evaluated associations between MIP and duration of mechanical ventilation with follow-up outcomes. Results 50 COVID-19 survivors discharged from ICU between 15 October 2020 and 1 April 2021 were enrolled. Overall, survivors showed a recovery trajectory over time. However, impaired MIP remained in 24 (48%) and 12 (24%) at 3 and 6 months, respectively. Diaphragm dysfunction was not observed. At 3 months, 23 (46%) had impaired functional capacity versus 10 (20%) at 6 months. Dyspnoea persisted in 44 (88%) patients at 3 months and 38 (76%) at 6 months. Quality of life was slightly decreased at 3 months with further improvements at 6 months. MIP was correlated to 6MWD, 6MWD % predicted, dyspnoea across follow-up, and quality of life at 3 months. The duration of invasive ventilation was correlated with 6MWD and 6MWD % predicted. Conclusion In invasively ventilated COVID-19 survivors, inspiratory muscle strength impairments persisted 6 months after ICU discharge, while maintaining normal diaphragm function. Decreased functional capacity, dyspnoea and slightly reduced health status were observed. Early screening of survivors is of utmost importance to identify those with impairments and at risk of delayed or incomplete recovery.http://openres.ersjournals.com/content/9/1/00329-2022.full |
| spellingShingle | Maria Natividad Núñez-Seisdedos David Valcárcel-Linares María Teresa Gómez-González Irene Lázaro-Navas Luís López-González Daniel Pecos-Martín Isabel Rodríguez-Costa Inspiratory muscle strength and function in mechanically ventilated COVID-19 survivors 3 and 6 months after intensive care unit discharge ERJ Open Research |
| title | Inspiratory muscle strength and function in mechanically ventilated COVID-19 survivors 3 and 6 months after intensive care unit discharge |
| title_full | Inspiratory muscle strength and function in mechanically ventilated COVID-19 survivors 3 and 6 months after intensive care unit discharge |
| title_fullStr | Inspiratory muscle strength and function in mechanically ventilated COVID-19 survivors 3 and 6 months after intensive care unit discharge |
| title_full_unstemmed | Inspiratory muscle strength and function in mechanically ventilated COVID-19 survivors 3 and 6 months after intensive care unit discharge |
| title_short | Inspiratory muscle strength and function in mechanically ventilated COVID-19 survivors 3 and 6 months after intensive care unit discharge |
| title_sort | inspiratory muscle strength and function in mechanically ventilated covid 19 survivors 3 and 6 months after intensive care unit discharge |
| url | http://openres.ersjournals.com/content/9/1/00329-2022.full |
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