Long-term assessment of functional capacity, muscle function, lung function, and quality of life in survivors of ventilator-associated pneumonia

Larissa Mello Dias; Jenipher Angel da Cruz; Agnaldo José Lopes

doi:10.1016/j.heliyon.2023.e23431

Long-term assessment of functional capacity, muscle function, lung function, and quality of life in survivors of ventilator-associated pneumonia

Heliyon. 2023 Dec 9;10(1):e23431. doi: 10.1016/j.heliyon.2023.e23431. eCollection 2024 Jan 15.

Authors

Larissa Mello Dias^{1

2

3}, Jenipher Angel da Cruz³, Agnaldo José Lopes^{1

4}

Affiliations

¹ Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.
² Faculty Inspirar, Curitiba, Brazil.
³ Worker's Hospital Complex, Curitiba, Brazil.
⁴ Local Development Post-Graduation Programme, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil.

Abstract

Background and objective: The many patients who develop ventilator-associated pneumonia (VAP) have generated numerous VAP survivors who are not followed up in the long term. This study aimed, primarily, to evaluate the long-term functional capacity, as measured using the Glittre-ADL test (TGlittre), of VAP survivors and, secondarily, to calculate the correlations of TGlittre with muscle and lung function.

Methods: This cross-sectional study evaluated 30 VAP survivors 10 months after discharge from the intensive care unit. The participants underwent the following assessments: TGlittre; respiratory muscle strength; handgrip strength (HGS); spirometry; Functional Assessment of Chronic Therapy (FACIT-F); and Short Form-36 (SF-36).

Results: The median TGlittre time was 95 (81-130)% of predicted, and 30 % of the participants performed poorly on TGlittre. One-third of the participants had abnormal spirometry results. TGlittre time was correlated with weight (r_s = -0.412, P = 0.023), body index mass (BMI, r_s = -0.400, P = 0.029), forced vital capacity (FVC, r_s = -0.401, P = 0.030), HGS (r_s = -0.571, P = 0.0009), FACIT-F score (r_s = -0.405, P = 0.026), and different SF-36 domain scores. Participants who returned to work had a shorter TGlittre time than those who did not (89 (69-104) vs. 129 (102-183)% predicted). Multiple linear regression indicated that FVC and BMI explained 39 % of TGlittre variability.

Conclusion: VAP survivors had suboptimal functional capacity, low lung function, and general fatigue 10 months after discharge. The longer the TGlittre time was, the worse the lung function, muscle function, general fatigue, and quality of life were and the less likely the patient was to have returned to work.

Keywords: Exercise; Mechanical ventilation; Quality of life; Rehabilitation; Ventilator-associated pneumonia.