Résumé
Les patients séjournant en réanimation développent fréquemment une faiblesse musculaire touchant les muscles des membres ainsi que les muscles respiratoires. Des difficultés de sevrage de la ventilation mécanique, une augmentation de la durée de séjour en réanimation et à l’hôpital ainsi qu’une diminution de la qualité de vie et des capacités physiques à long terme sont les conséquences attendues et bien décrites de la faiblesse musculaire. L’évaluation de la force musculaire semble nécessaire pour dépister le développement d’une faiblesse musculaire, la quantifier, pour adapter les exercices aux capacités des patients et pour évaluer les effets des traitements. Ceci explique l’intérêt suscité à développer des outils objectifs, fiables et sensibles pour mesurer la force musculaire en réanimation. Néanmoins, plusieurs facteurs peuvent altérer la qualité des mesures et rendre leur interprétation parfois complexe. Cet article décrit et discute les différents tests de mesure de force musculaire, des membres et du système respiratoire.
Abstract
Patients staying in the intensive care unit (ICU) frequently develop muscle weakness involving limbs and respiratory muscles. Difficulty in weaning from mechanical ventilation, increased length of stay in ICU and hospital, reduced quality of life, and physical long-term disabilities are expected well-described consequences of weak muscle. The assessment of muscle strength seems necessary to recognize and quantify muscle weakness, adapt the exercise to the patient’s capabilities, and evaluate the effects of the administered treatment. It explains the interest to develop objective, reliable, and sensitive tools to measure muscle strength in the ICU. However, several factors can affect the quality of measurements and complicate sometimes their interpretation. This article describes and reviews the different tests that can be performed in the ICU clinical practice to measure muscle strength.
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Dousse, N., Vermeulen, F. & Brochard, L. Comment, en pratique clinique, évaluer la force musculaire du patient de réanimation ?. Réanimation 23, 109–115 (2014). https://doi.org/10.1007/s13546-013-0827-z
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DOI: https://doi.org/10.1007/s13546-013-0827-z