Perioperatively Acquired Weakness.

Abstract

BACKGROUND:

Skeletal muscle failure in critical illness (intensive care unit-acquired weakness) is a well-known complication developing early during intensive care unit stay. However, muscle weakness during the perioperative setting has not yet been investigated.

METHODS:

We performed a subgroup investigation of a prospective observational trial to investigate perioperative muscle weakness. Eighty-nine patients aged 65 years or older were assessed for handgrip strength preoperatively, on the first postoperative day, at intensive care unit discharge, at hospital discharge, and at 3-month follow-up. Functional status was evaluated perioperatively via Barthel index, instrumental activities of daily living, Timed Up and Go test, and functional independence measure. After exclusion of patients with intensive care unit-acquired weakness or intensive care unit stay of ≥72 hours, 59 patients were included into our analyses. Of these, 14 patients had additional pulmonary function tests preoperatively and on postoperative day 1. Blood glucose was measured intraoperatively every 20 minutes.

RESULTS:

Handgrip strength significantly decreased after surgery on postoperative day 1 by 16.4% (P < .001). Postoperative pulmonary function significantly decreased by 13.1% for vital capacity (P = .022) and 12.6% for forced expiratory volume in 1 second (P = .001) on postoperative day 1. Handgrip strength remained significantly reduced at hospital discharge (P = .016) and at the 3-month follow-up (P = .012). Perioperative glucose levels showed no statistically significant impact on muscle weakness. Instrumental activities of daily living (P < .001) and functional independence measure (P < .001) were decreased at hospital discharge, while instrumental activities of daily living remained decreased at the 3-month follow-up (P = .026) compared to preoperative assessments.

CONCLUSIONS:

Perioperatively acquired weakness occurred, indicated by a postoperatively decreased handgrip strength, decreased respiratory muscle function, and impaired functional status, which partly remained up to 3 months.

• Authors: Gunnar Lachmann, Rudolf Mörgeli, Sophia Kuenz, Sophie K Piper, Claudia Spies, Maryam Kurpanik, Steffen Weber-Carstens, Tobias Wollersheim, BIOCOG Consortium
• Journal: Anesthesia and analgesia (Anesth Analg) Vol. 130 Issue 2 Pg. 341-351 (02 2020) ISSN: 1526-7598 [Electronic] United States
• PMID: 30855340 (Publication Type: Clinical Trial, Journal Article, Observational Study, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Female
• Hand Strength (physiology)
• Humans
• Intensive Care Units (trends)
• Male
• Muscle Weakness (diagnosis, etiology, physiopathology)
• Postoperative Complications (diagnosis, etiology, physiopathology)
• Prospective Studies
• Respiratory Muscles (physiology)