INFLUÊNCIA DA FRAQUEZA MUSCULAR PERIFÉRICA NA FALHA DE EXTUBAÇÃO EM PACIENTES CRÍTICOS.

This study aims to evaluate the influence of peripheral muscule strength on extubation failure in critical ill patients. This is a pilot, longitudinal, quantitative and prospective study with 100 adult patients admitted to intensive care unit with more than 48 hours of mechanical ventilation. Muscle strength was evaluate using the Medical Research Council scale and dynamometry. Data distribution was evaluated using the Kolmogorov-Smirnov test. Continuous variables with asymmetrical distribution were expressed as medians and interquartile ranges and compared using the Mann-Whitney test. Categorical variables were expressed in absolute and relative frequencies and compared using the chi-square test. P values <0.05 were considered significant. The median of Medical Research Council score in patients with extubation failure was 38 days, with an interquartile range (IQR) of 37- 42, and 52,5 days (IQR 40,5-58) in patients with extubation success (p=0,001). Dynamometry evaluation showed a median of 6,6 points (IQR 3,8-9,3) in patients with extubation failure and 12,6 (IQR 7,8-19,7) in patients who evolved successfully (p= 0,001). Of the patients who failed extubation, 78,0% had an MRC below 48 (p=0,007). The median length of stay in the ICU was 26 days (IQR 21-34,5) in patients with extubation failure and 9 days (IQR 6-14) in patients with extubation success (p=0,009), 44,4% of patients who failed extubation evolved to tracheostomy, against only 2,1% of those who evolved successfully (p=<0,001). About the mortality, 55,0% of the patients who required reintubation died, against 9,8% of the patients with success (p=<0,001). It was concluded that the presence of peripheral muscle weakness was not associated with the risk of reintubation, but a greater number of patients with MRC <48 and higher mortality rates were identified in the extubation failure subgroup. [ABSTRACT FROM AUTHOR]