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Cardiorespiratory Fitness and Neuromuscular Function of Mechanically Ventilated ICU COVID-19 Patients*

Authors :
Guillaume Y. Millet
Djahid Kennouche
Clément Foschia
Callum G. Brownstein
Julien Gondin
Thomas Lapole
Diana Rimaud
Nicolas Royer
Guillaume Thiery
Vincent Gauthier
Lydia Oujamaa
Marine Sorg
Samuel Vergès
Stéphane Doutreleau
Mathieu Marillier
Mélanie Prudent
Laurent Bitker
Léonard Féasson
Laurent Gergelé
Emeric Stauffer
Céline Guichon
Jérôme Morel
SALAS, Danielle
Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM )
Université Claude Bernard Lyon 1 (UCBL)
Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])
Institut Universitaire de France (IUF)
Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche (M.E.N.E.S.R.)
CHU Saint-Etienne
Institut NeuroMyoGène (INMG)
Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1)
Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)
Clinique Mutualiste Chirurgicale [Saint-Étienne]
Hypoxie et PhysioPathologie (HP2)
Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA)
Centre Hospitalier Universitaire [Grenoble] (CHU)
Hospices Civils de Lyon (HCL)
Hôpital de la Croix-Rousse [CHU - HCL]
Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS)
Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon)
Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Hôpital privé de la Loire - Ramsay Santé (HPL-RS)
Source :
Critical Care Medicine, Critical Care Medicine, 2022, Online ahead of print. ⟨10.1097/CCM.0000000000005641⟩
Publication Year :
2022
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2022.

Abstract

International audience; Objectives: The aim of the present study was to investigate the level of cardiorespiratory fitness and neuromuscular function of ICU survivors after COVID-19 and to examine whether these outcomes are related to ICU stay/mechanical ventilation duration.Design: Prospective nonrandomized study.Setting: Patients hospitalized in ICU for COVID-19 infection.Patients: Sixty patients hospitalized in ICU (mean duration: 31.9 ± 18.2 d) were recruited 4-8 weeks post discharge from ICU.Interventions: None.Measurements and main results: Patients visited the laboratory on two separate occasions. The first visit was dedicated to quality of life questionnaire, cardiopulmonary exercise testing, whereas measurements of the knee extensors neuromuscular function were performed in the second visit. Maximal oxygen uptake (V o2 max) was 18.3 ± 4.5 mL·min -1 ·kg -1 , representing 49% ± 12% of predicted value, and was significantly correlated with ICU stay/mechanical ventilation (MV) duration ( R = -0.337 to -0.446; p < 0.01 to 0.001), as were maximal voluntary contraction and electrically evoked peak twitch. V o2 max (either predicted or in mL· min -1 ·kg -1 ) was also significantly correlated with key indices of pulmonary function such as predicted forced vital capacity or predicted forced expiratory volume in 1 second ( R = 0.430-0.465; p ≤ 0.001) and neuromuscular function. Both cardiorespiratory fitness and neuromuscular function were correlated with self-reported physical functioning and general health status.Conclusions: V o2 max was on average only slightly above the 18 mL·min -1 ·kg -1 , that is, the cut-off value known to induce difficulty in performing daily tasks. Overall, although low physical capacities at admission in ICU COVID-19 patients cannot be ruled out to explain the association between V o2 max or neuromuscular function and ICU stay/MV duration, altered cardiorespiratory fitness and neuromuscular function observed in the present study may not be specific to COVID-19 disease but seem applicable to all ICU/MV patients of similar duration.

Details

ISSN :
00903493 and 15300293
Volume :
50
Database :
OpenAIRE
Journal :
Critical Care Medicine
Accession number :
edsair.doi.dedup.....45d5ce750babe4c7aeda945b054876c7
Full Text :
https://doi.org/10.1097/ccm.0000000000005641