TY - JOUR T1 - Specialized Weaning Unit in the Trajectory of SARS-CoV-2 ARDS: Influence of Limb Muscle Strength on Decannulation and Rehabilitation JF - Respiratory Care DO - 10.4187/respcare.09602 SP - respcare.09602 AU - Morgane Faure AU - Maxens Decavèle AU - Elise Morawiec AU - Martin Dres AU - Nicolas Gatulle AU - Julien Mayaux AU - François Stefanescu AU - Julien Caliez AU - Thomas Similowski AU - Julie Delemazure AU - Alexandre Demoule Y1 - 2022/05/31 UR - http://rc.rcjournal.com/content/early/2022/05/31/respcare.09602.abstract N2 - BACKGROUND: Patients with ARDS due to coronavirus disease 2019 (COVID-19) may require tracheostomy and transfer to a weaning center. To date, data on the outcome of these patients are scarce. The objectives of this study were to determine the factors associated with time to decannulation and limb-muscle strength recovery.METHODS: This was an observational retrospective study of subjects with COVID-19–related ARDS requiring tracheostomy after prolonged ventilation, who were subsequently transferred to a weaning center from April 4, 2020–May 30, 2020.RESULTS: Forty-three subjects were included. Median age (interquartile range) was 61 (48–66) y; 81% were men, and median body mass index (BMI) was 30 (26–35) kg/m2. Tracheostomy was performed after a median of 19 (12–27) d of mechanical ventilation, and the median ICU length of stay prior to transfer to the weaning center was 30 (21–46) d. On admission to the weaning center, the median Medical Research Council (MRC) score was 36 (27–44). Time to decannulation was 9 (7–18) d after admission to the weaning center. The only factor independently associated with early decannulation was the MRC score on admission to the weaning center (odds ratio 1.16 [95% CI 1.06–1.31], P = .005). Two factors were independently associated with MRC gain ≥ 10: BMI (odds ratio 0.88 [95% CI 0.76–0.99], P = .045) and MRC on admission (odds ratio 0.91 [95% CI 0.82–0.98], P = .03. Three months after admission to the weaning center, 40 subjects (93%) were weaned from mechanical ventilation and 36 (84%) had returned home.CONCLUSIONS: MRC score at weaning center admission predicted both early decannulation and limb-muscle strength recovery. ER -