Intensive care unit-acquired weakness

Appleton, Richard; Kinsella, John

doi:10.1093/bjaceaccp/mkr057

Cited by 127 publications

(27 citation statements)

References 12 publications

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“…Table 4 presents several trials examining NMBA use in patients with status asthmaticus. ICU-AW is reported in this population (93) and appears to be more commonly associated with the use of concomitant high-dose steroids (94)(95)(96)(97)(98). A recent retrospective study in mechanically ventilated patients with status asthmaticus suggested that patients who require deep sedation with persistent immobilization are still at risk for weakness, despite a decline in the duration of induced paralysis (97).…”

Section: Status Asthmaticusmentioning

confidence: 93%

The Use of Neuromuscular Blocking Agents in the ICU

Greenberg

Vender

2013

Critical Care Medicine

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Intensivists use neuromuscular blocking agents for a variety of clinical conditions, including for emergency intubation, acute respiratory distress syndrome, status asthmaticus, elevated intracranial pressure, elevated intra-abdominal pressure, and therapeutic hypothermia after ventricular fibrillation-associated cardiac arrest. The continued creation and use of evidence-based guidelines and protocols could ensure that neuromuscular blocking agents are used and monitored appropriately. A collaborative multidisciplinary approach coupled with constant review of the pharmacology, dosing, drug interactions, and monitoring techniques may reduce the adverse events associated with the use of neuromuscular blocking agents.

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Section: Status Asthmaticusmentioning

confidence: 93%

The Use of Neuromuscular Blocking Agents in the ICU

Greenberg

Vender

2013

Critical Care Medicine

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“…Outcomes recorded included survival, length of PICU and hospital admission, and other complications, including organ failure, need for extracorporeal support, renal replacement therapy and neurological outcomes including prolonged neuromuscular weakness. Prolonged neuromuscular weakness was defined as the presence of clinically detected weakness at discharge from PICU where there was no plausible aetiology other than critical illness . The duration of weakness was recorded and rehabilitation reports reviewed.…”

Section: Methodsmentioning

confidence: 99%

Severe group A streptococcal infections in a paediatric intensive care unit

Lithgow

Duke

Steer

et al. 2014

J Paediatrics Child Health

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“…Intensive care unit-acquired weakness (ICUAW) often leads to prolonged periods of mechanical ventilation and life-changing disability, 1 with patients demonstrating reduced fitness and health-related quality of life up to 5 years after discharge. 2 For these patients, early rehabilitation and mobilisation is essential, facilitating liberation from mechanical ventilation, optimising recovery and improving the chance of survival.…”

Section: Introductionmentioning

confidence: 99%

eLearning to facilitate the education and implementation of the Chelsea Critical Care Physical Assessment: a novel measure of function in critical illness

2016

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ObjectiveTo evaluate the efficacy of eLearning in the widespread standardised teaching, distribution and implementation of the Chelsea Critical Care Physical Assessment (CPAx) tool—a validated tool to assess physical function in critically ill patients.DesignProspective educational study. An eLearning module was developed through a conceptual framework, using the four-stage technique for skills teaching to teach clinicians how to use the CPAx. Example and test video case studies of CPAx assessments were embedded within the module. The CPAx scores for the test case studies and demographic data were recorded in a secure area of the website. Data were analysed for inter-rater reliability using intraclass correlation coefficients (ICCs) to see if an eLearning educational package facilitated consistent use of the tool. A utility and content validity questionnaire was distributed after 1 year to eLearning module registrants (n=971). This was to evaluate uptake of the CPAx in clinical practice and content validity of the CPAx from the perspective of clinical users.SettingThe module was distributed for use via professional forums (n=2) and direct contacts (n=95).ParticipantsCritical care clinicians.Primary outcome measureICC of the test case studies.ResultsBetween July and October 2014, 421 candidates from 15 countries registered for the eLearning module. The ICC for case one was 0.996 (95% CI 0.990 to 0.999; n=207). The ICC for case two was 0.988 (0.996 to 1.000; n=184). The CPAx has a strong total scale content validity index (s-CVI) of 0.94 and is well used.ConclusionseLearning is a useful and reliable way of teaching psychomotor skills, such as the CPAx. The CPAx is a well-used measure with high content validity rated by clinicians.

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Intensive care unit-acquired weakness

Cited by 127 publications

References 12 publications

The Use of Neuromuscular Blocking Agents in the ICU

The Use of Neuromuscular Blocking Agents in the ICU

Severe group A streptococcal infections in a paediatric intensive care unit

eLearning to facilitate the education and implementation of the Chelsea Critical Care Physical Assessment: a novel measure of function in critical illness

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