Association between hand grip strength with weaning and intensive care outcomes in COPD patients: A pilot study

Abstract

BackgroundIn COPD, weight loss and muscle wasting contribute significantly to morbidity, disability, and handicap. Dominant‐handgrip strength for evaluation of muscle strength has not been tested as a parameter to predict outcome of weaning from mechanical ventilation (MV).ObjectivesTo evaluate the association between handgrip strength and the duration and success of weaning and extubation outcome.Materials and methodsThis prospective study included 34 COPD patients requiring MV for at least 48 hours. Recovery from sedation and muscle relaxants was assessed before recruitment. Serial meseaurment of handgrip strength were assessed by trained personnel.ResultsThere was a significant negative correlation between baseline hand grip and duration of MV (P = .047, r = −.343). The mean day 5 hand grip was significantly lower in person who died compared to survivors (5.7 ± 5.5 vs 18.2 ± 14.5, P = .044). The mean day 5 hand grip was significantly lower in patients who needed reintubation compared to those in patients who did not need reintubation (2.8 ± 2 vs 17.2 ± 13.9, P = .029). There was no significant difference in the mean baseline, day 2, day 3, day 4 and day 5 hand grip in weaning success compared to those in failure (P > .05).ConclusionHandgrip strength may be good predictor for duration of MV, extubation outcome, ICU mortality and prognosis.

Handgrip Strength and Pulmonary Disease in the Elderly: What is the Link?

“…In a recent retrospective study with a longitudinal follow-up of 60 patients with severe COPD followed for 7 years, Pleguezuelos et al [91] observed that both HGS and ischiocrural strength (but not quadriceps strength) were independent predictors of mortality. Interestingly, HGS has also been suggested as a good predictor of duration of mechanical ventilation, extubation outcome, and mortality in COPD patients admitted to the intensive care unit [92] .…”

Handgrip strength measurement in patients with chronic obstructive pulmonary disease: Possible predictor of exercise capacity

“…Moreover, HGS has been shown to have a stronger correlation with quality of life, including activities of daily living, in patients with COPD compared with those without COPD, but it was not associated with the degree of air flow limitation in the COPD group [35]. Another study found that HGS may be a good predictor of mechanical ventilation duration, extubation outcomes, intensive care unit mortality, and prognosis [36]. In several clinical populations (e.g., obese or healthy elderly populations) and in Japanese cohort studies, HGS was shown to be significantly correlated with the 6MWD and physical activity [37][38][39].…”

<p>Grip Strength: An Indispensable Biomarker For Older Adults</p>

“…100 For patients with chronic obstructive pulmonary disease Mohamed-Hussein et al noted a significant difference in mean grip strength between patients admitted to the intensive care who died (5.7kg) compared to those who survived (14.5kg). 101 As grip strength explains function cross-sectionally, it also predicts future function and changes in function over time. Over 10 years ago Bohannon published a systematic review in which he included the results of 9 studies investigating the value of grip strength as a predictor of future function.…”