Assessment of diaphragmatic dysfunction in patients under mechanical ventilation in intensive care units and its correlation with sarcopenia and mortality
“Respiration, Artificial, Diaphragm, Ultrasonics, Sarcopenia, Mortality, Quadriceps Muscle, Intensive Care Units
“Introduction: Mechanical ventilation is a fundamental therapeutic tool in treating critically ill patients, especially those with respiratory failure. However, it also increases morbidity and mortality when its use is prolonged. Among the consequences are diaphragmatic dysfunction, which is very prevalent but still underdiagnosed through the employment of bedside diaphragmatic ultrasound. Sarcopenia, also common in intensive care patients, is a factor related to longer mechanical ventilation. Standardization and systematization of the diagnostic technique for diaphragmatic dysfunction using bedside ultrasound can facilitate detecting such changes, assisting in managing the patient being evaluated. Objectives: To assess the association of diaphragmatic dysfunction and loss of muscle mass in the quadriceps femoris by serial bedside ultrasound assessment with 28-day mortality in mechanically ventilated adults in intensive care units. Material and methods: Prospective cohort study that consecutively included all patients over 18 years of age admitted to the adult ICU of the University Hospital of Brasília who presented acute respiratory failure requiring invasive mechanical ventilation for more than 48 hours during the data collection period. Results: Early detection of diaphragmatic dysfunction in intubated patients using bedside ultrasound, as well as detection of sarcopenia in this group of patients and its correlation in prevalence with diaphragmatic dysfunction, correlating with 28-day mortality. Higher mortality and prevalence of sarcopenia are expected to be found in individuals with diaphragmatic dysfunction.”