Predisposing factors for critical illness polyneuromyopathy in a multidisciplinary intensive care unit

Nanas, Serafim; Kritikos, K.; Angelopoulos, E; Siafaka, A; Tsikriki, S; Poriazi, M; Kanaloupiti, D.; Kontogeorgi, M; Pratikaki, Maria; Zervakis, Dimitrios; Routsi, Christina; Roussos, Charis

doi:10.1111/j.1600-0404.2008.00996.x

Cited by 131 publications

(172 citation statements)

References 37 publications

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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

149

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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

149

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“…Mechanical ventilation is another risk factor for CIP [20] as well as the severity of illness at the time of ICU admission [34] and multiorgan failure [35]. Parenteral nutrition has been suggested to be a risk factor for CIP [20,36] as well as side effects of administered drugs e.g.…”

Section: Risk Factors and Pathophysiologymentioning

confidence: 99%

“…Parenteral nutrition has been suggested to be a risk factor for CIP [20,36] as well as side effects of administered drugs e.g. aminoglycosid antibiotics [18,34].…”

Section: Risk Factors and Pathophysiologymentioning

confidence: 99%

“…In addition, it has been shown that high blood glucose levels are associated to the development of CIP [16,34,45] and a linear relationship has been demonstrated between blood glucose levels and the risk to develop CIP [46]. It has been hypothesized that hyperglycemia and relative insulin deficiency may hamper nerve function caused by direct neurotoxic effects e.g.…”

Section: Risk Factors and Pathophysiologymentioning

confidence: 99%

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Neurological Sequelae of Sepsis: II) Neuromuscular Weakness

Axer¹

2011

TOCCMJ

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Abstract:Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) have been established as separate entities of muscular weakness in critically ill patients, although both may be associated to each other in some respects. Both are associated to systemic inflammatory response syndrome, sepsis, and severe sepsis. Major signs of nerve and muscle disturbances in critically ill patients are muscle weakness and problems of weaning from the ventilator. Electroneurographic measurements help to detect CIP early in the course of the disease, while muscle biopsy seems to date the diagnostic tool of choice to detect CIM. Sepsis therapy is the major target to prevent the development of CIP and CIM. However, no specific therapy of CIP and CIM has been established in the past. Therefore, management of patients with CIP and CIM is mainly supportive. Neuromuscular weakness cause elongated times of ventilation, elongated hospital stay, elongated times of rehabilitation, and increased mortality. This review provides an overview of clinical and diagnostic features of CIP and CIM, and summarizes current pathophysiological and therapeutic concepts.

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“…В то же время появилось понимание того, что тяжесть и отдален-ный прогноз зависят не только от выраженности основ-ной патологии. Дополнительным фактором, отягощаю-щим состояние пациента в ОРИТ, является мышечная слабость (МС) -intensive care unit-acquired weakness [1]. Она является одной из наиболее частых проблем, наблю-даемых у пациентов, госпитализированных в ОРИТ, и ха-рактеризуется симметричным двусторонним снижением мышечной силы, не связанным с предшествующим нерв-но-мышечным заболеванием.…”

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Rehabilitation in the intensive care unit: electrical stimulation of skeletal muscles

Безденежных¹,

Сумин²

2016

Kardiol. serdechno-sosud. khir.

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Predisposing factors for critical illness polyneuromyopathy in a multidisciplinary intensive care unit

Abstract: CIPM has a high incidence in the ICU setting. Our study revealed the association of aminoglycosides, hyperglycemia and illness severity with CIPM development, as well as the association between Gram (-) bacteremia and development of CIPM in less severely ill patient population.

Cited by 131 publications

References 37 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

Neurological Sequelae of Sepsis: II) Neuromuscular Weakness

Rehabilitation in the intensive care unit: electrical stimulation of skeletal muscles

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