Critical illness polyneuropathy in multiple organ dysfunction syndrome and weaning from the ventilator

Leijten, Frans S.S.; Weerd, A.W. de; Poortvliet, D.C.J.; Ridder, Victor A. de; Ulrich, C.; Weerd, J. E. Harinck-De

doi:10.1007/s001340050178

Cited by 54 publications

(103 citation statements)

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“…Eleven out of the 29 (38%) 25,28,29,32,[36][37][38][39][40][41][42] observational studies were graded of low quality, 17 out of 29 (59%) 12,[14][15][16]20,24,26,27,30,[43][44][45][46][47][48][49][50] as medium and one (3%) 51 as high quality. There were four RCTs included; two studies were deemed of low risk, 22,23 one unclear risk 8 and one with high risk 31 of bias.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

The incidence of intensive care unit-acquired weakness syndromes: A systematic review

Appleton

Kinsella

Quasim

2014

Journal of the Intensive Care Society

150

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We conducted a literature review of the intensive care unit-acquired weakness syndromes (critical illness polyneuropathy, critical illness myopathy and critical illness neuromyopathy) with the primary objective of determining their incidence as a combined group. Studies were identified through MEDLINE, Embase, Cochrane Database and article reference list searches and were included if they evaluated the incidence of one or more of these conditions in an adult intensive care unit population. The incidence of an intensive care unit-acquired weakness syndrome in the included studies was 40% (1080/2686 patients, 95% confidence interval 38-42%). The intensive care unit populations included were heterogeneous though largely included patients receiving mechanical ventilation for seven or more days. Additional prespecified outcomes identified that the incidence of intensive care unit-acquired weakness varied with the diagnostic technique used, being lower with clinical (413/1276, 32%, 95% CI 30-35%) compared to electrophysiological techniques (749/1591, 47%, 95% CI 45-50%). Approximately a quarter of patients were not able to comply with clinical evaluation and this may be responsible for potential underreporting of this condition.

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Section: Quality Of Included Studiesmentioning

confidence: 99%

The incidence of intensive care unit-acquired weakness syndromes: A systematic review

Appleton

Kinsella

Quasim

2014

Journal of the Intensive Care Society

150

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“…CIM has been reported in at least one third of ICU patients treated for status asthmaticus [8] and studies of critically ill patients suggest incidence rates between 12-35% [9][10][11][12]. Prospective studies suggest that CIP may occur in up to 50-70% of patients admitted to the ICU with a diagnosis of systemic inflammatory response syndrome (SIRS) [13][14][15]. In a recent systematic review of 24 studies reporting data for 1421 patients, the overall median prevalence of NMD was 46% (95% confidence interval 43-49%) in adult subjects with either sepsis, multi-organ failure, or prolonged mechanical ventilation (median duration, 7 days) [7].…”

Section: Incidence Of Acquired Neuromuscular Dysfunction In the Icumentioning

confidence: 99%

“…Sepsis and SIRS has been associated with NMD in a number of prospective studies [14,15,[21][22][23]. Severity of critical illness and organ dysfunction scores predicts NMD in multivariable analyses.…”

Section: Risk Factors For Acquired Neuromuscular Weaknessmentioning

confidence: 99%

“…Prospective studies in patients ventilated for over seven days have reported increased hospital mortality associated with NMD [13,15,24]. In fact, the development of NMD early in the course of critical illness may predict mortality.…”

Section: Prognosis Of Icu-acquired Nmdmentioning

confidence: 99%

“…The presence of NMD is also associated with clinically significant short and long-term morbidity. Both CIM and CIP are associated with prolonged duration of mechanical ventilation and increased length of hospital and ICU stay [13,15,35]. Thus the presence of acquired paresis can inform the clinical decision to pursue early tracheostomy and arrange for long-term care after hospital discharge.…”

Section: Prognosis Of Icu-acquired Nmdmentioning

confidence: 99%

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Mechanisms of Neuromuscular Dysfunction in Critical Illness

Khan

Harrison

Rich

2008

Critical Care Clinics

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The development of neuromuscular dysfunction (NMD) during critical illness is increasingly recognized as a cause of failure to wean from mechanical ventilation and is associated with significant morbidity and mortality. At times it is difficult to identify the presence of NMD and distinguish the etiology of the weakness in patients with critical illness, but subtle clinical findings and bedside electrophysiological testing are helpful in establishing the diagnosis. The purpose of this review is to describe the clinical spectrum of acquired neuromuscular weakness in the setting of critical illness, provide an approach to diagnosis, and to discuss its pathogenesis. Finally, we propose defective sodium channel regulation as a unifying mechanism underlying NMD in critically ill patients.

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Paresis Acquired in the Intensive Care Unit<SUBTITLE>A Prospective Multicenter Study</SUBTITLE>

Jonghe

Sharshar²,

Lefaucheur³

et al. 2002

JAMA

1,319

937

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Critical illness polyneuropathy in multiple organ dysfunction syndrome and weaning from the ventilator

Abstract: Axonal polyneuropathy is related to the severity of multiple-organ-dysfunction syndrome. Its presence does not necessarily implicate difficult weaning from artificial ventilation.

Cited by 54 publications

References 0 publications

The incidence of intensive care unit-acquired weakness syndromes: A systematic review

The incidence of intensive care unit-acquired weakness syndromes: A systematic review

Mechanisms of Neuromuscular Dysfunction in Critical Illness

Paresis Acquired in the Intensive Care Unit<SUBTITLE>A Prospective Multicenter Study</SUBTITLE>

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