New device for nonvolitional evaluation of quadriceps force in ventilated patients
- 1 May 2018
- journal article
- research article
- Published by Wiley in Muscle & Nerve
- Vol. 57 (5), 784-791
- https://doi.org/10.1002/mus.26026
Abstract
IntroductionIn mechanically ventilated patients, nonvolitional assessment of quadriceps weakness using femoral-nerve stimulation (twitch force) while the leg rests on a right-angle trapezoid or dangles from the bed edge is impractical. Accordingly, we developed a knee-support apparatus for use in ventilated patients. MethodsNinety subjects (12 ventilated patients, 28 ambulatory patients, and 50 healthy subjects) were enrolled. Twitches with leg-dangling, trapezoid, and knee-support setups were compared. ResultsKnee-support twitches were similar to trapezoid twitches but smaller than leg-dangling twitches (P<0.0001). Inter- and intraoperator agreement was high for knee-support twitches at 1 week and 1 month. In ventilated patients, knee-support twitches were smaller than in healthy subjects and ambulatory patients (P<0.004). DiscussionThe new knee-support apparatus allows accurate recording of quadriceps twitches. The ease of use in ventilated patients and excellent inter- and intraoperator agreement suggest that this technique is suitable for cross-sectional and longitudinal studies in critically ill patients. Muscle Nerve57: 784-791, 2018Keywords
Funding Information
- National Institutes of Health
- National Science Foundation
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