Early Assessment of Quadriceps Muscle Recovery by Dynamometry and 3D Ultrasound in Intensive Care Patients Under Invasive Mechanical Ventilation

Early Assessment of Quadriceps Muscle Recovery by Dynamometry and 3D Ultrasound in Intensive Care Patients Under Invasive Mechanical Ventilation: A Monocentric and Prospective Study.

Patients in intensive care often develop acquired muscle weakness (ICUAW or Intensive Care Unit Acquired Weakness) due to immobilization and muscle atrophy. Early mobilization can help reduce weakness and improve functional recovery, but practices vary. Muscle strength assessment, particularly using the MRC (Medical Research Council) score, is crucial, though it has precision limitations. Additional methods, such as manual dynamometry and functional scales, are needed to better track muscle recovery. The quadriceps, important for function, requires early evaluation, but there is a lack of specific data in intensive care to predict medium-term functional recovery.

Inclusion Criteria:

• Adults aged > 18 years
• Hospitalized in an ICU
• Treated with invasive mechanical ventilation (MV) for at least 4 days during their stay (may be extubated at the time of inclusion)
• Conscious and cooperative patients: ability to respond appropriately to the following commands: open and close eyes, look at me, nod your head, stick out your tongue, raise your eyebrows when I count to five
• MRC score ≥ 3/5 for the "Leg Extension" function on either the left or right side
• Informed consent obtained (no opposition)

Exclusion Criteria:

• Pregnant or breastfeeding women
• Fracture or amputation of a lower limb
• Acute or chronic brain or spinal cord injury responsible for hemiplegia or paraplegia
• Unstable spinal injury
• Neurodegenerative or chronic neurological disease
• Guillain-Barré Syndrome
• Myasthenia Gravis
• Acute deep vein thrombosis of the lower limbs treated within the last 48 hours
• Pre-existing motor deficit in a lower limb before the ICU stay, of any cause
• Incarcerated or legally protected individuals (guardianship, curatorship)
• Individuals without social protection