Critical illness polyneuropathy and myopathy: a review of evidence and the implications for weaning from mechanical ventilation and rehabilitation

Physiotherapy ◽  
2007 ◽  
Vol 93 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Emily Ricks
Keyword(s):  
Mechanical Ventilation ◽  
Critical Illness ◽  
Critical Illness Polyneuropathy ◽  
Weaning From Mechanical Ventilation

scholarly journals The Critical Illness Polyneuropathy in Septic Patients With Prolonged Weaning From Mechanical Ventilation: Is the Diaphragm Also Affected? A Pilot Study

2012 ◽  
Vol 57 (10) ◽  
pp. 1594-1601 ◽  
Author(s):  
Patrícia dos Santos ◽  
Cassiano Teixeira ◽  
Augusto Savi ◽  
Juçara Gasparetto Maccari ◽  
Fernanda Santos Neres ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critical Illness ◽  
Pilot Study ◽  
Critical Illness Polyneuropathy ◽  
Weaning From Mechanical Ventilation ◽  
Prolonged Weaning

scholarly journals Simplified Diagnosis of Critical Illness Polyneuropathy in Patients with Prolonged Mechanical Ventilation: A Prospective Observational Cohort Study

2020 ◽  
Vol 9 (12) ◽  
pp. 4029
Author(s):  
Chul Jung ◽  
Nak-Jun Choi ◽  
Won Jun Kim ◽  
Yoon Mok Chun ◽  
Hak-Jae Lee ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critical Illness ◽  
Clinical Outcomes ◽  
Diagnostic Criteria ◽  
Early Identification ◽  
Prolonged Mechanical Ventilation ◽  
Critical Illness Polyneuropathy ◽  
Single Center Study ◽  
Sum Score ◽  
Observational Cohort

Background: Although early identification of critical illness polyneuropathy (CIP) is necessary, the established diagnostic criteria have several limitations in the intensive care unit (ICU) setting. The purpose of this study was to define simplified diagnostic criteria of CIP that best predict clinical outcomes. Methods: This prospective, single-center study included 41 ICU patients with prolonged mechanical ventilation (≥21 days). We applied three different sets of diagnostic criteria (combining the results of the Medical Research Council (MRC) sum score and nerve conduction studies (NCS)) for CIP in order to identify the criteria with the best predictive power for clinical outcomes. Results: The simplified diagnosis of CIP meeting the criteria, i.e., that the MRC sum score < 48 and amplitudes of the tibial and sural nerve < 80% of the lower limit of normal, showed the strongest association with 0 ventilator-free days at day 60 (odds ratio, 6.222; p = 0.029). Conclusions: The diagnostic criteria combining the MRC sum score and the tibial and the sural NCS were identified as the simplified criteria of CIP that best predicted the clinical outcomes. The implementation of these simplified criteria may allow for early identification of CIP in the ICU, thereby contributing to prompt interventions for patients with a poor prognosis.

Effect of critical illness polyneuropathy on the withdrawal from mechanical ventilation and the length of stay in septic patients*

2005 ◽  
Vol 33 (2) ◽  
pp. 349-354 ◽  
Author(s):  
Jose Garnacho-Montero ◽  
Rosario Amaya-Villar ◽  
Jose Luis García-Garmendía ◽  
Juan Madrazo-Osuna ◽  
Carlos Ortiz-Leyba
Keyword(s):  
Mechanical Ventilation ◽  
Critical Illness ◽  
Length Of Stay ◽  
Critical Illness Polyneuropathy

scholarly journals Critical Illness Polyneuropathy in Children with Infectious Diseases

2019 ◽  
Vol 7 (2) ◽  
pp. 6-8
Author(s):  
V.B. Voitenkov ◽  
◽  
A.V. Klimkin ◽  
N.V. Skripchenko ◽  
A.A. Vilnits
Keyword(s):  
Mechanical Ventilation ◽  
Critical Illness ◽  
Infectious Diseases ◽  
Critical Illness Polyneuropathy ◽  
Lower Limbs ◽  
Critically Ill Children ◽  
Diagnostic Process ◽  
Severe Condition ◽  
Different Types ◽  
Sensory Fibers

Our goal was to establish electrophysiological features of critical illness polyneuropathy in children with infectious diseases. Materials and Methods: We evaluated peripheral nervous system involvement in 67 critically ill children, admitted in ICU with different types of infectious diseases (viral encephalitis, meningoencephalitis, meningitis, acute gastroenteritis). Age of the group varied from 4 months to 17 years. All patients underwent conduction studies and neurological investigation. Sensory and motor fibers of n. ulnaris et n. medianus, motor fibers of n. Tibialis and sensory fibers of n. Suralis were tested. Lowering of the amplitudes, conduction velocity slowing and asymmetry were accounted for the motor and sensory fibers. Results: In 47 cases (n=71) diagnosis of critical illness polyneuropathy (CIP) was established. Lesions mostly involved lower limbs nerves. According to our data, severe course of CIP was seen in 40% of all cases. Average time of CIP onset in children was 5-7 days from the beginning of mechanical ventilation. Conclusions: Critical illness polyneuropathy in children with infectious diseases is a severe condition which may lead to the disability of the patients. Average time of its onset is the 5-7 days from the beginning of the mechanical ventilation in 71% of the patients. More often sensory and motor fibers of lower limbs nerves are affected. Conduction studies is a valuable tool in diagnostic process in establishing the critical illness polyneuropathy in children with infectious diseases. Keywords: Critical illness, critical illness polyneuropathy, children, electromyography.

scholarly journals Healthcare trajectories before and after critical illness: population-based insight on diverse patients clusters

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Youenn Jouan ◽  
Leslie Grammatico-Guillon ◽  
Noémie Teixera ◽  
Claire Hassen-Khodja ◽  
Christophe Gaborit ◽  
...  
Keyword(s):  
Septic Shock ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Critical Illness ◽  
Length Of Stay ◽  
Population Based ◽  
Hospital Length Of Stay ◽  
Healthcare Use ◽  
Icu Admission ◽  
Icu Discharge

Abstract Background The post intensive care syndrome (PICS) gathers various disabilities, associated with a substantial healthcare use. However, patients’ comorbidities and active medical conditions prior to intensive care unit (ICU) admission may partly drive healthcare use after ICU discharge. To better understand retative contribution of critical illness and PICS—compared to pre-existing comorbidities—as potential determinant of post-critical illness healthcare use, we conducted a population-based evaluation of patients’ healthcare use trajectories. Results Using discharge databases in a 2.5-million-people region in France, we retrieved, over 3 years, all adult patients admitted in ICU for septic shock or acute respiratory distress syndrome (ARDS), intubated at least 5 days and discharged alive from hospital: 882 patients were included. Median duration of mechanical ventilation was 11 days (interquartile ranges [IQR] 8;20), mean SAPS2 was 49, and median hospital length of stay was 42 days (IQR 29;64). Healthcare use (days spent in healthcare facilities) was analyzed 2 years before and 2 years after ICU admission. Prior to ICU admission, we observed, at the scale of the whole study population, a progressive increase in healthcare use. Healthcare trajectories were then explored at individual level, and patients were assembled according to their individual pre-ICU healthcare use trajectory by clusterization with the K-Means method. Interestingly, this revealed diverse trajectories, identifying patients with elevated and increasing healthcare use (n = 126), and two main groups with low (n = 476) or no (n = 251) pre-ICU healthcare use. In ICU, however, SAPS2, duration of mechanical ventilation and length of stay were not different across the groups. Analysis of post-ICU healthcare trajectories for each group revealed that patients with low or no pre-ICU healthcare (which represented 83% of the population) switched to a persistent and elevated healthcare use during the 2 years post-ICU. Conclusion For 83% of ARDS/septic shock survivors, critical illness appears to have a pivotal role in healthcare trajectories, with a switch from a low and stable healthcare use prior to ICU to a sustained higher healthcare recourse 2 years after ICU discharge. This underpins the hypothesis of long-term critical illness and PICS-related quantifiable consequences in healthcare use, measurable at a population level.

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