Interest of hand grip strength to predict outcome in mechanically ventilated patients

Abstract

Background: Weaning from mechanical ventilation is a crucial process for critically ill patients. Hand grip strength (HGS) is an assessment tool for respiratory muscle function to assist guidance of extubation.

Objective: To evaluate HGS as a predictor for in-hospital clinical outcomes in mechanically ventilated patients.

Methods: A prospective study was conducted. Patients requiring mechanical ventilation with tracheal intubation in medical wards and intensive care units were recruited. HGS, reintubation, number of ventilator-free days and mortality were recorded.

Results: A total of 34 patients (52.9% men) were included. When compared to the non re-intubation group, the re-intubation group had significantly lower HGS at 10 min and 30 min after starting spontaneous breathing trial (7.6 ± 4.8 kg Vs 13.4 ± 6.5 kg, P = 0.045, and 8 ± 5.1 kg Vs 13.2 ± 5.7 kg, P = 0.047). Moreover, at 1 h and 48 h of post extubation, the re-intubation group had lower HGS than the non re-intubation group. HGS at 1 h of post extubation was positively correlated with ventilator-free day at 28 days (r = 0.34, P = 0.05). HGS did not differ between survival group and death group in hospital over time.

Conclusions: Hand grip strength may be a predictive tool for extubation failure in mechanically ventilated patients. Low strength corresponded to significantly increased re-intubation rate. Furthermore, this measurement could not predict in-hospital mortality.

Keywords: Extubation failure; Hand grip strength; Mechanical ventilation; Mortality; Reintubation.