• Paula C Fontela, Sheila S Glaeser, Luciane Fg Martins, Robledo L Condessa, Douglas T Prediger, Soraia Gi Forgiarini, Luiz A Forgiarini, Thiago C Lisboa, and Gilberto Friedman.
• Pneumological Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
• Respir Care. 2021 May 1; 66 (5): 733741733-741.

BackgroundHandgrip strength is an alternative measure to assess peripheral muscle strength and is correlated with the Medical Research Council (MRC) scale, with promising values for diagnosing ICU-acquired weakness (ICUAW). Because ICUAW has been associated with delayed weaning from mechanical ventilation, we hypothesized that ICUAW evaluated with both the MRC scale score and handgrip strength are associated with failure of a spontaneous breathing trial (SBT) and duration of mechanical ventilation weaning.MethodsWe conducted a prospective observational study in 3 general ICUs with a total of 54 beds at 2 academic hospitals. Adult subjects with > 48 h of mechanical ventilation who were eligible for weaning were included in the study.ResultsIn the evaluation before the first SBT, the MRC score (P < .001) and handgrip strength (P < .001) were significantly different between subjects extubated after a successful first SBT (simple weaning) and those extubated any time after a failed first SBT (difficult weaning). Only the MRC score discriminated between first SBT success or failure (P < .001); in multivariate analysis, the MRC score was significantly associated with first SBT failure (odds ratio 0.91, 95% CI 0.88-0.97, P < .001) and difficult weaning (odds ratio 0.91, 95% CI 0.87-0.96, P < .001). Handgrip strength exhibited good accuracy in identifying ICUAW.ConclusionsMRC score was independently associated with SBT failure and difficult or prolonged weaning.Copyright © 2021 by Daedalus Enterprises.

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