Economic impact of prolonged motor weakness complicating neuromuscular blockade in the intensive care unit

Rudis, Maria I.; Guslits, Benjamin J.; Peterson, Edward L.; Hathaway, Stephen J.; Angus, Elizabeth M.; Beis, Sara; Zarowitz, Barbara J.

doi:10.1097/00003246-199610000-00024

Cited by 91 publications

(41 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…44 Aminoglycoside antibiotics were associated with paresis in a single study; however, additional observational studies demonstrated no significant association. 6,34,36,39,40 There are single studies suggesting that other potentially modifiable ICU interventions, including liberal fluid administration and transfusion, journal.publications.chestnet.org may contribute to ICUAW, although these associations need verification in larger patient cohorts. 45,46 Prolonged immobilization is associated with atrophy in patients who are critically ill.…”

Section: In-hospital Risk Factors For Icuawmentioning

confidence: 99%

ICU-Acquired Weakness

Jolley

Bunnell

Hough

2016

Chest

267

229

View full text Add to dashboard Cite

Survivorship after critical illness is an increasingly important health-care concern as ICU use continues to increase while ICU mortality is decreasing. Survivors of critical illness experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay. Newfound impairment is associated with increased health-care costs and use, reductions in health-related quality of life, and prolonged unemployment. Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in patients who are critically ill, with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysfunction. ICU-acquired weakness (ICUAW) is associated with longer durations of mechanical ventilation and hospitalization, along with greater functional impairment for survivors. Although there is increasing recognition of ICUAW as a clinical entity, significant knowledge gaps exist concerning identifying patients at high risk for its development and understanding its role in long-term outcomes after critical illness. This review addresses the epidemiologic and pathophysiologic aspects of ICUAW; highlights the diagnostic challenges associated with its diagnosis in patients who are critically ill; and proposes, to our knowledge, a novel strategy for identifying ICUAW.

show abstract

Section: In-hospital Risk Factors For Icuawmentioning

confidence: 99%

ICU-Acquired Weakness

Jolley

Bunnell

Hough

2016

Chest

267

229

View full text Add to dashboard Cite

show abstract

“…However, recent prospective and retrospective studies have shown that this is an under-appreciated entity, which is a significant source of morbidity in the ICU, and has significant economic consequences on the usage of health resources. [2][3][4] There is compelling evidence that this syndrome is associated with altered muscle membrane properties and selective loss of myosin and myosin-associated proteins. The altered membrane properties are most probably the primary cause of the absent or very low compound muscle action potentials and the increased amount of spontaneous EMG activity.…”

Section: Discussionmentioning

confidence: 99%

Acute quadriplegic myopathy following autologous peripheral blood stem cell transplantation for breast cancer

Samuelsson¹,

Zackrisson

Tokics³

et al. 1999

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:Autologous peripheral blood stem cell transplantation (APSCT) is increasingly used in the treatment of breast cancer. We report a patient who experienced septic shock, and after treatment with antibiotics, high-dose corticosteroids and mechanical ventilation due to respiratory insufficiency, developed quadriplegia. Electroneurophysiological examination, as well as a muscle biopsy, showed a typical picture of acute quadriplegic myopathy with loss of thick filament proteins. This is, to the best of our knowledge, the first reported case of this complication following APSCT.

show abstract

“…The use of protocols based on monitoring of the desired blockade can reduce the mechanical ventilation time, the length of ICU stay and costs. (87,88) 13. Is the use of any specific drug for analgesia and sedation of tetanus patients associated with improved outcomes?…”

Section: Rationalementioning

confidence: 99%