Characterization of fatigue, cardiorespiratory and neuromuscular function in patients with ICU stay ; Caractérisation de la fatigue et des fonctions cardiorespiratoire et neuromusculaire chez des patients ayant séjourné en unité de réanimation

During their stay in intensive care unit (ICU), patients often faced critical alterations which will have consequences in the short term (i.e. during the stay) but also at long term following ICU discharge. The objective of this thesis was to follow the course of a patient from his/her arrival in the ICU until several months after his/her discharge. A first study allowed us to validate the use of a tool to monitor the neuromuscular function of sedated patients and thus potentially anticipate the occurrence of ICU acquired weakness. Through the second study, we determined the consequences of an ICU stay following Covid-19 infection on the cardiorespiratory function. These results, coupled with the frequently reported complaints, from both Covid-19 patients and patients having stayed in ICU, led us to investigate more precisely the reported fatigue. Thus, a third study highlighted significant differences in maximal voluntary activation and lung capacity between self-reported fatigued and non-fatigued patients. Finally, we investigated the recovery of these patients several months after ICU discharge. We reported that despite a significant improvement in quality of life, perceived fatigue and cardiorespiratory and neuromuscular functions, the patients remained below the predictive values for most of the investigated parameters. This work has provided new insights on the consequences of ICU stay, especially following Covid-19 infection, providing interesting approaches for rehabilitation. ; Lors du séjour en réanimation les patients font face à des altérations souvent critiques de leur état qui auront des conséquences à court terme (i.e. pendant le séjour) mais aussi à distance de la sortie du service de réanimation. L’objectif de ce travail de thèse était de suivre le parcours d’un patient de son arrivée en réanimation jusqu’à plusieurs mois après sa sortie. Une 1ère étude nous a permis de valider l’utilisation d’un outil pouvant monitorer la fonction neuromusculaire des patients sédatés et ainsi potentiellement ...