PP155 - QUADRICEPS MUSCLE CHANGES AND SWALLOWING RECOVERY AFTER WEANING FROM MECHANICAL VENTILATION
PP155
QUADRICEPS MUSCLE CHANGES AND SWALLOWING RECOVERY AFTER WEANING FROM MECHANICAL VENTILATION
V. A. Fugas1,2,3,*, V. A. Tell1,2, P. Astegiano1,2,3, M. D. Vago3,4, C. A. Zucchella2, N. I. Carrizo2
1Unidad de Soporte Nutricional, 2Unidad de Terapia Intensiva, 3Equipo Interdisciplinario de Disfagia, 4Servicio de Fonoaudiología, Hospital Dr. José María Cullen, Santa Fe, Argentina
Rationale: Muscle impairment is common during critical illness and may affect recovery. Its relationship with swallowing recovery is plausible but not well established.
Methods: Prospective observational study. Mechanically ventilated ICU adults (>48 h) were followed from ICU admission to swallowing recovery (event), discharge, referral, or death. Swallowing recovery was defined as GUSS-ICU=10. Quadriceps muscle layer thickness (QMLT) was measured by ultrasound at admission and first post-weaning swallowing assessment, according to institutional protocol. Patients with both measurements, informed consent, and complete follow-up were included. Daily percentage QMLT change was calculated. ICU-acquired weakness (ICUAW) at first post-weaning swallowing assessment was defined as MRC-SS <48. Kaplan–Meier and log-rank test were used. QMLT change was categorized by mean (≤ vs >), adjusted for time between measurements.
Results: Of 23 patients, 82.6% (n=19) reached the event. Tracheostomy was present in 47.8% and 39.1% had malnutrition (GLIM) at admission. ICUAW occurred in 43.5%. QMLT showed a significant overall decrease (3.09 ± 1.00 to 2.34 ± 0.70 cm; ~24%; p<0.001). In Kaplan–Meier analyses, time to the event did not differ by sex or malnutrition at admission (log-rank p=0.310 and 0.583). Tracheostomy was associated with longer time to the event (48 vs 11 days; p<0.001). QMLT change was not associated with time to swallowing recovery (32 vs 25 days; p=0.843). ICUAW was not associated with longer time to the event (48 vs 25 days; p=0.135).
Conclusion: Although QMLT significantly decreased during critical illness, it was not associated with swallowing recovery after weaning from mechanical ventilation. This suggests that peripheral muscle loss alone may not reflect swallowing recovery trajectories in ICU survivors, and that neuromuscular function and muscle quality may be more relevant than structural loss alone.
Disclosure of Interest: V. Fugas Grant / Research Support from: ESICM fellowship 2024 sponsored by Fresenius Kabi, Speakers Bureau of: Invited speaker, Fresenius Kabi webinar (2025), V. Tell: None declared, P. Astegiano: None declared, M. Vago: None declared, C. Zucchella: None declared, N. Carrizo: None declared