Alterations in Respiratory and Limb Muscle Strength and Size in Patients With Sepsis Who Are Mechanically Ventilated

Background. Skeletal muscle wasting and weakness are common in patients with sepsis in the intensive care unit, although less is known about deficits in diaphragm and limb muscles when mechanical ventilation also is required. Objective. The objective of this study was to concurrently investigate relative differences in both thickness and strength of respiratory and peripheral muscles during routine care. Design. A prospective, cross-sectional study of 16 alert patients with sepsis and 16 people who were healthy (control group) was used. Methods. Assessment was made of the diaphragm, upper arm, forearm, and thigh muscle thicknesses with the use of ultrasound; respiratory muscle strength by means of maximal inspiratory pressure; and isometric handgrip, elbow flexion, and knee extension forces with the use of portable dynamometry. To describe relative changes, data also were normalized to fat-free body mass (FFM) measured by bioelectrical impedance spectroscopy. Results. Patients (9 men, 7 women; mean age62 years, SD17) were assesse