Erworbene Muskelschwäche des kritisch Kranken

Abstract

The diagnosis of intensive care unit acquired weakness (ICUAW) in the setting of neurological rehabilitation is steadily increasing. This is due to the fact that the intensive care of patients with sepsis or after cardiac or abdominal surgery is improving. A longer duration of respiratory weaning and comorbidities frequently complicate rehabilitation. Clinically, patients present with a flaccid (tetra) paresis and electrophysiological studies have shown axonal damage. Besides involvement of peripheral nerves, muscle can also be affected (critical illness myopathy) leading to ICUAW with inconstant myopathic damage patterns found by electrophysiological testing. Mixed forms can also be found. A specific therapy for ICUAW is not available. Early mobilization to be initiated on the intensive care unit and commencing neurological rehabilitation improve the outcome of ICUAW. This review highlights the current literature regarding the etiology and diagnosis of ICUAW. Furthermore, studies about rehabilitation and outcome of ICUAW are discussed.

Influence of Antibiotic Management on Microbial Selection and Infectious Complications After Trauma

“…On the other hand, it is quite plausible that patients who have suffered a post-traumatic infection also have a higher disability rate. Longer periods of respiratory weaning and comorbidities often complicate rehabilitation, including critical illness myopathy, which leads to Intensive care unit acquired weakness (ICUAW) (25). Open fractures and major skin injuries do not appear to have a relevant influence on the development of an infectious post-traumatic complication.…”

Dysphagia—A Common, Transient Symptom in Critical Illness Polyneuropathy

“…CIP is commonly observed after ICU treatment of sepsis and cardiac or visceral surgery (23)(24)(25)(26)(27). Clinically, patients with CIP show a flaccid tetraplegia and prolonged weaning durations (WDs).…”