Abstract
ABSTRACT Patients that leave intensive care for intermediate care present compromised muscle strength and functionality. In this context, our main objective was to describe the correlation between functional independence and handgrip strength in adult patients at intermediate care unit (IMCU). This was an analytical, correlational, and prospective study that compared patients admitted to IMCU after a stay of more than 24 hours in intensive care, with invasive or non-invasive ventilatory support. We used Barthel index (BI) and hand dynamometry at admission/discharge from IMCU. In total, 69 patients were included, 62.3% were men, with an average age of 63 years and a stay in intermediate care of five days. On admission to IMCU, 31.9% had complete dependence and 66.7% severe dependence. The most compromised categories were "bathroom use" and "stairs". On the other hand, "dressing" was the one with the greatest improvement (admission 24.6%, discharge 82.5%). A positive correlation [(r=0.4) and (p=0.000)] was identified between functionality and grip strength at admission and was maintained at discharge [(r=0.6) and (p=0.000)]. We identified a positive correlation between BI scores and handgrip strength, remaining stronger at IMCU discharge.
Highlights
METHODSIntermediate Care Units (IMCU) are responsible for the management of patients that require continuous monitoring, once they are no longer at critical risk[1]
Patients that survived a critical illness at the Intensive Care Unit (ICU) are sent to the intermediate care unit (IMCU), arriving there with health issues generated by prolonged rest and muscle weakness acquired in the ICU (ICUAW )
When the level of functional independence was analyzed by groups of patients that received ventilatory support, we found that the group that received IMV upon admission to the IMCU had an average Barthel index (BI) score of 33.8±17.2 points and those who received non-invasive mechanical ventilation (NIMV) 27±13.8 points (p=0.15)
Summary
Intermediate Care Units (IMCU) are responsible for the management of patients that require continuous monitoring, once they are no longer at critical risk[1]. Patients that survived a critical illness at the Intensive Care Unit (ICU) are sent to the IMCU, arriving there with health issues generated by prolonged rest and muscle weakness acquired in the ICU (ICUAW ) This adds to the individual health condition, causing a decrease in their functional capacity and their muscle strength, which results in a cost increase due to prolonged hospital stay[2,3]. Evidences emphasize the importance of assessing functional independence and muscle strength in critically ill patients[2,4,5]; studies evaluating the follow-up of these variables during stay in the IMCU are scarce. We aimed at describing the correlation between functional independence and handgrip strength in adult patients in an IMCU and comparing the level of functionality upon admission and discharge. For intra-evaluator reliability, investigator #1 obtained an ICC of 0.93 and investigator #2 of 0.94, indicating coherence
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