TY - JOUR T1 - Prevalence and impact of inspiratory muscles dysfunction at ICU discharge in patients admitted for acute respiratory failure: Preliminary results of a prospective study JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P4899 AU - Dan Adler AU - Elise Dupuis-Lozeron AU - Laurent Brochard AU - Janssens Jean-Paul Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P4899.abstract N2 - Critical illness polyneuromyopathy predicts poor outcome. This is in part related to diaphragmatic dysfunction. Prevalence and impact of inspiratory muscle dysfunction in patients who have survived an episode of acute hypercapnic respiratory failure (AHRF) in the ICU is not known.Sniff nasal pressure (Pnas) was measured at day 7 after ICU discharge in 40 consecutive patients surviving an episode of AHRF. Inspiratory muscle dysfunction was defined as Pnas < 5th percentile. Demographic variables, lung physiology, SAPSII and early hospital, RICU and ICU readmission (<day 45) were analysed.26 patients (65%) were diagnosed with COPD and 22 patients (55%) with obesity. Median Pnas value was 46.0 cmH20 [IQR: 39.5; 61.5]. 27 patients (69%) had inspiratory muscle dysfunction with a median Pnas value of 44 cmH20 [IQR: 35.5; 46], whereas only 12 patients (31%) had a normal inspiratory muscle function with a median Pnas value of 66 cmH20 [IQR: 57.5; 68.5]. Higher FEV1 was associated with normal inspiratory muscle strength (OR 0.95, [CI95: 0.89-0.98], p=0.009) . FEV1 and BMI were positively correlated with Pnas (linear coefficient regression, 0.30, [CI95: 0.07-0.53], p=0.013, respectively linear coefficient regression, 0.55; [CI95: 0.12-0.98], p=0.016). Inspiratory muscle dysfunction was associated with early ward, RICU and ICU readmission (log rank test, p= 0.021).Inspiratory muscle dysfunction is frequent after an episode of AHRF in the ICU and is associated with early hospital, RICU and ICU readmission. Higher BMI and FEV1 are correlated with improved inspiratory muscle strength. ER -