DOI QR코드

DOI QR Code

인공호흡기(ventilator)를 사용하는 중환자의 사지둘레와 사지근육면적 변화에 관한 연구

Study on the Changes in Limb Circumferences and Muscle Areas of Critically Ill Patients using Ventilators

  • 발행 : 2008.12.31

초록

Purpose: The purpose of this study was to identify muscle atrophy in critically ill patients on ventilators. A comparison was made between limb circumferences and muscle areas on the day of admission to an intensive care unit (ICU) and on the 8th day after admission. Methods: The data were collected from 30 critically ill patients using ventilators at S hospital ICU in Seoul during the period from October 2005 to April 2006. Limb circumferences and skinfold thickness were measured on the day of admission and on the 8th day after admission to the ICU. Limb circumferences and skinfold thickness were measured on the right mid-arm, right mid-thigh, and right mid-calf using a measuring tape and a skinfold calipers. Limb muscle areas were calculated by an equation after measuring limb circumferences and skinfold thickness. The data were analyzed by paired t-test and independent t-test. Results: 1) Mid-arm circumference, mid-thigh circumference and mid-calf circumference on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 2) Mid-arm muscle area, mid-thigh muscle area and mid-calf muscle area on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 3) Steroid and vecuronium medication didn't affect changes in limb circumferences (mid-arm, mid-thigh, mid-calf) and muscle areas (mid-arm, mid-thigh, mid-calf on the 8th day after admission to the ICU compared to the day of admission. Conclusion: Limb muscle atrophy may occur on the 8th day after admission to the ICU in critically ill patients using ventilator.

키워드

참고문헌

  1. Akima, H., Kuno, S., Suzuki, Y., Gunji, A., & Fukunaga, T. (1997). Effects of 20 days of bed rest on physiological cross-sectional area of human thigh and leg muscles evaluated by magnetic resonance imaging. Journal of Gravitional Physiology, 4, S15-S21
  2. Arnold, J., Campbell, I. T., Samuels, T. A., Devlin, J. C., Green, C. J., Hipkin, L. J., et al. (1993). Increased whole body protein breakdown predominates over increased whole body protein synthesis in multiple organ failure. Clinical Science, 84, 655-661 https://doi.org/10.1042/cs0840655
  3. Chae, Y. R., & Choe, M. A. (1994). Effect of a decreased activity following THRA on circumference, volume and strength of normal and operated lower extremities. Journal of Korean Academy of Nursing, 24, 115-128
  4. Choe, M. A. (1991). Changes in skinfold thickness, circumference and muscle strength of extremities of hospitalized patients. The Seoul Journal of Nursing, 5, 23-34
  5. Choe, M. A. (1999, February). Muscle atrophy and exercise. Paper presented at the workshop of the Korean Society of Sports Medicine, Seoul
  6. Choe, M. A., & Chi, J. G. (1993). Effect of periodic weight support on type 1 muscle of developing suspended rats: Animal experiment for nursing intervention of muscle atrophy in children. Journal of Korean Academy of Nursing, 23, 207-223
  7. Choe, M. A., Choi, J. A., & Shin, G. S. (1997). Effect of regular exercise during dexamethasone injection on the body weight, weight of hindlimb muscle and adrenal gland in young rats. Journal of Korean Academy of Nursing, 27, 510-519
  8. Cohen, J. (1988). Statistical power analysis for the behavior science (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Association Pub
  9. Dekhuijzen, P. N., Gayan-Ramirez, G., Bisschop, A., deBock, V., Dom, R., Bouillon, R., et al. (1995). Rat diaphragm contractility and histopathology are affected differently by low dose treatment with methylprednisolone and deflazacort. The European Respiratory Journal, 8, 824-830
  10. Frank, L. M., & Detchans, L. W. (1992). Skeletal muscle pathology (2nd ed.). Edinburgh, NY: Churchill Livingstone
  11. Helliwell, T. R., Wilkinson, A., Griffiths, R. D., McClelland, P., Palmer, T. E., & Bone, J. M. (1998). Muscle fibre atrophy in critically ill patients is associated with the loss of myosin filaments and the presence of lysosomal enzymes and ubiquitin. Neuropathology and Applied Neurobiology, 24, 507-517 https://doi.org/10.1046/j.1365-2990.1998.00144.x
  12. Hong, S. B. (2003). Survey of patients using mechanical ventilators in intensive care unit in Korea. Paper presented at the meeting of the Korean Academy of Tuberculosis and Respiratory Diseases, Seoul
  13. Kasper, C. E., Talbot, L. A., & Gaines, J. M. (2002). Skeletal muscle damage and recovery. AACN Clinical Issues, 13, 237-247 https://doi.org/10.1097/00044067-200205000-00009
  14. Kim, Y. J. (2001, November). Midazolam in intensive care unit. Paper presented at the meeting of the Korean Society for Anesthetic Pharmacology, Seoul
  15. Koh, Y. S. (2003). Survey of patients using mechanical ventilators over 72 hr in intensive care unit in Korea. Paper presented at the meeting of the Korean Academy of Tuberculosis and Respiratory Diseases, Seoul
  16. Laaban, J. P., Kouchakji, B., Dore, M. F., Orvoen-Frija, E., David, P., & Rochemaure, J. (1993). Nutritional status of patients with chronic obstructive pulmonary disease and acute respiratory failure. Chest, 103, 1362-1368 https://doi.org/10.1378/chest.103.5.1362
  17. Moukas, M., Vassiliou, M. P., Amyqdalou, A., Mandraqos, C., Takis, F., & Behraakis, P. K. (2002). Muscular mass assessed by ultrasonography after administration of low-dose corticosteroids and muscle relaxants in critically ill hemiplegic patients. Clinical Nutrition, 21, 297-302 https://doi.org/10.1054/clnu.2001.0532
  18. Nava, S., Gayan-Ramirez, G., Rollier, H., Bisschop, A., Dom, R., Bock, V., et al. (1996). Effects of acute steroid administration on ventilatory and peripheral muscles in rats. American Journal of Respiratory and Critical Care Medicine, 153, 1888-1896 https://doi.org/10.1164/ajrccm.153.6.8665051
  19. Park, E. K., Lim, H. S., & Lee, J. H. (2001). Degree of enteral tube feeding in the intensive care unit and change in nutritional status. Journal of the Korean Dietetic Association, 7, 217-226
  20. Reid, C. L., Campbell, I. T., & Little, R. A. (2004). Muscle wasting and energy balance in critical illness. Clinical Nutrition, 23, 273-280 https://doi.org/10.1016/S0261-5614(03)00129-8
  21. Song, J. W., Oh, Y. M., Sim, T. S., Im, C. M., Lee, S. D., Kim, W. S., et al. (2003). Cause disease and result of mechanical ventilator therapy in medical intensive care unit of a university hospital. Paper presented at the meeting of the Korean Academy of Tuberculosis and Respiratory Diseases, Seoul
  22. Yoon, B. C., Lee, M. H., Kim, N. S., Hong, H. J., & Yu, B. K. (2001). Comparison of muscle atrophy induced by cast fixation, denervation and suspension of rat hindlimb. The Journal of Korean Society of Physical Therapy, 13, 665-675

피인용 문헌

  1. 중환자 통증사정을 위한 한국어판 Critical care Pain Observation Tool (CPOT)의 신뢰도 및 타당도 검증 vol.42, pp.1, 2012, https://doi.org/10.4040/jkan.2012.42.1.76
  2. Measurement of Muscle Mass as a Nutritional Assessment Tool in Critically Ill Patients vol.30, pp.2, 2013, https://doi.org/10.32429/jkshp.2013.30.2.003
  3. Effects of functional training on strength, function level, and quality of life of persons in intensive care units vol.8, pp.3, 2008, https://doi.org/10.14474/ptrs.2019.8.3.134