Should we abandon manual muscle strength testing in the ICU 英文参考文献.docVIP

Hermans and Gosselink Critical Care 2011,15:127 /content/15/2/127 COMMENTARY Should we abandon manual muscle strength testing in the ICU? Greet Hermans and Rik Gosselink * 1 2 See related research by Hough et al., /content/15/1/R43 several issues. Although the study was set up to evaluate the MRC sum score in critically ill patients, only one- third of the results were obtained in the ICU and the majority of patients were studied post ICU. Indeed, decreased conscious ness limits the feasibility of the MRC score in the ICU [4,8]. Nevertheless, 28% [4] to 78% [8] of patients sur vived to awakening and were evaluable in the ICU, which is much higher than the 7% (10/135) reported in Hough and colleagues’ paper. Abstract Intensive-care-unit-acquired weakness is a major complication in critically ill patients. The paper by Hough and coworkers suggests that the current method of manual muscle strength testing with the Medical Research Council sum score is of limited value in the intensive care unit. However, their results raise a number of questions and provide important lessons for implementation of such evaluations in the intensive care unit. e high reliability of diagnosing ICUAW in the post- ICU setting con? rms previous ? nding e very low agreement found by Hough and colleagues in the ICU (κ = 0.38), however, may be due to several methodological issues. Intensive-care-unit-acquired weakness (ICUAW) is a major complication in critically ill patients e paper by Firstly, stringent criteria for levels of cooperation were Hough and colleagues addresses the feasibility and lacking. Ful? llment of only three out of ? ve criteria for reliability of manual muscle testing in the intensive care adequacy was require is low number indicates sub- unit (ICU) [1]. ICUAW is associated with prolonged optimal cognitive function,