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Hwang and Choe: Study on the Changes in Limb Circumferences and Muscle Areas of Critically Ill Patients using Ventilators
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2008; 38(6): 874-880.

Published online: 31 December 2008

DOI: https://doi.org/10.4040/jkan.2008.38.6.874

Study on the Changes in Limb Circumferences and Muscle Areas of Critically Ill Patients using Ventilators

Young-Hui Hwang1, Myoung-Ae Choe2

1Doctoral Student, Department of Nursing, Seoul National University, Seoul, Korea.

2Professor, Department of Nursing, Seoul National University, Seoul, Korea.

Address reprint requests to: Hwang, Young Hui. Department of Nursing, Graduate School, Seoul National University, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Korea. Tel: 82-2-2112-5496, Fax: 82-2-2112-5554, ihui@snuh.org

Received 10 June 2008       Accepted 14 November 2008

Copyright © 2008 Korean Society of Nursing Science

Abstract

Purpose

The purpose of this study was to identify muscle atrophy in critically ill patients on ventilators. A comparison was made between limb circumferences and muscle areas on the day of admission to an intensive care unit (ICU) and on the 8th day after admission.

Methods

The data were collected from 30 critically ill patients using ventilators at S hospital ICU in Seoul during the period from October 2005 to April 2006. Limb circumferences and skinfold thickness were measured on the day of admission and on the 8th day after admission to the ICU. Limb circumferences and skinfold thickness were measured on the right mid-arm, right mid-thigh, and right mid-calf using a measuring tape and a skinfold calipers. Limb muscle areas were calculated by an equation after measuring limb circumferences and skinfold thickness. The data were analyzed by paired t-test and independent t-test.

Results

1) Mid-arm circumference, mid-thigh circumference and mid-calf circumference on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 2) Mid-arm muscle area, mid-thigh muscle area and mid-calf muscle area on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 3) Steroid and vecuronium medication didn't affect changes in limb circumferences (mid-arm, mid-thigh, mid-calf) and muscle areas (mid-arm, mid-thigh, mid-calf) on the 8th day after admission to the ICU compared to the day of admission.

Conclusion

Limb muscle atrophy may occur on the 8th day after admission to the ICU in critically ill patients using ventilator.

Keywords: Muscular atrophy, Ventilators-mechanical, Critically ill patients, Neuromuscular agents, Steroids

Figures and Tables

Table 1
Characteristics of the Subjects (N=30)
jkan-38-874-i001

*Values on the day of admission.

COPD=chronic obstructive pulmonary disease; Tb=tuberculosis.

Table 2
Mean Daily Dose of Midazolam, Vecuronium, and/or Steroid, and Mean Daily Calorie Intake (N=30)
jkan-38-874-i002

ER=energy requirement.

Table 3
Limb Circumferences of Critically Ill Patients using Ventilators on the 8th Day After Admission to Intensive Care Unit (N=30)
jkan-38-874-i003

*p<.05.

Table 4
Limb Muscle Areas of Critically Ill Patients using Ventilators on the 8th Day After Admission to Intensive Care Unit (N=30)
jkan-38-874-i004

*p<.05.

Table 5
Limb Circumferences and Limb Muscle Areas on the 8th Day after Admission compared to the Day of Admission by Steroid and Vecuronium Medication (N=30)
jkan-38-874-i005

*p<.05; †values on the 8th day after admission - values on the day of admission.

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