• Paulo Eugênio Silva, Vinicius Maldaner, Luciana Vieira, Karina Livino de Carvalho, Hedian Gomes, Priscilla Melo, Nicolas Babault, Gerson Cipriano, and Durigan Joao Luiz Quagliotti JLQ Assistant Professor, Physical Therapy Division, University of Brasilia, Brasília, DF, Brazil..
• Physical Therapy Division, University Hospital of Brasília, University of Brasilia, Brasília, DF, Brazil; Health Sciences and Technologies PhD Program, University of Brasilia, DF, Brazil; Physical Therapy Division, Hospital de Base do Distrito Federal, Brasilia, DF, Brazil. Electronic address: pauloeugenio.bsb@gmail.com.
• J Crit Care. 2018 Apr 1; 44: 87-94.

PurposeIt is unclear whether the muscular changes in mechanically-ventilated traumatic brain injury patients (TBI) are only associated with disuse or additionally to neuromuscular electrophysiological disorders (NED). The correlation between muscle atrophy and NED may affect functional outcomes and rehabilitation programs significantly.Material And MethodsAn observational study was performed to investigate the presence of NED and muscle atrophy in TBI patients undergoing mechanical ventilation. NED was diagnosed by the stimulus electrodiagnosis test when chronaxie was ≥1000μs. The muscle structure (thickness and echogenicity) was assessed by B-mode ultrasound. Tibialis anterior (TA), rectus femoris (RF), and biceps brachialis (BB) muscles were analyzed. Patients were followed from the first day of admission in the intensive care unit (ICU) to the fourteenth day.ResultsTwenty-two patients were analyzed. An increase of 48% in NED from day 1 to day 14 was detected in TA (p=0.004). All muscles presented a significant decrease in thickness (~18%, p<0.05), but echogenicity increased only in TA (19%), p<0.01 and RF (23%), p<0.01.ConclusionsMechanically-ventilated patients with TBI developed NED in addition to changes in muscle structure during their stay in the ICU.Copyright © 2017 Elsevier Inc. All rights reserved.

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