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.

scholarly journals Neuromuscular Electrical Stimulation for Intensive Care Unit–Acquired Weakness: Protocol and Methodological Implications for a Randomized, Sham-Controlled, Phase II Trial

2012 ◽  
Vol 92 (12) ◽  
pp. 1564-1579 ◽  
Author(s):  
Michelle E. Kho ◽  
Alexander D. Truong ◽  
Roy G. Brower ◽  
Jeffrey B. Palmer ◽  
Eddy Fan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Electrical Stimulation ◽  
Critical Illness ◽  
Pilot Study ◽  
Muscle Strength ◽  
Phase Ii ◽  
Neuromuscular Electrical Stimulation ◽  
Bed Rest

BackgroundAs the population ages and critical care advances, a growing number of survivors of critical illness will be at risk for intensive care unit (ICU)–acquired weakness. Bed rest, which is common in the ICU, causes adverse effects, including muscle weakness. Consequently, patients need ICU-based interventions focused on the muscular system. Although emerging evidence supports the benefits of early rehabilitation during mechanical ventilation, additional therapies may be beneficial. Neuromuscular electrical stimulation (NMES), which can provide some muscular activity even very early during critical illness, is a promising modality for patients in the ICU.ObjectiveThe objectives of this article are to discuss the implications of bed rest for patients with critical illness, summarize recent studies of early rehabilitation and NMES in the ICU, and describe a protocol for a randomized, phase II pilot study of NMES in patients receiving mechanical ventilation.DesignThe study was a randomized, sham-controlled, concealed, phase II pilot study with caregivers and outcome assessors blinded to the treatment allocation.SettingThe study setting will be a medical ICU.ParticipantsThe study participants will be patients who are receiving mechanical ventilation for 1 day or more, who are expected to stay in the ICU for an additional 2 days or more, and who meet no exclusion criteria.InterventionThe intervention will be NMES (versus a sham [control] intervention) applied to the quadriceps, tibialis anterior, and gastrocnemius muscles for 60 minutes per day.MeasurementsLower-extremity muscle strength at hospital discharge will be the primary outcome measure.LimitationsMuscle strength is a surrogate measure, not a patient-centered outcome. The assessments will not include laboratory, genetic, or histological measures aimed at a mechanistic understanding of NMES. The optimal duration or dose of NMES is unclear.ConclusionsIf NMES is beneficial, the results of the study will help advance research aimed at reducing the burden of muscular weakness and physical disability in survivors of critical illness.

Person-centred care during prolonged weaning from mechanical ventilation, nurses’ views: an interview study

2018 ◽  
Vol 46 ◽  
pp. 32-37 ◽  
Author(s):  
Carl-Johan Cederwall ◽  
Sepideh Olausson ◽  
Louise Rose ◽  
Silvana Naredi ◽  
Mona Ringdal
Keyword(s):  
Mechanical Ventilation ◽  
Interview Study ◽  
Weaning From Mechanical Ventilation ◽  
Prolonged Weaning

scholarly journals Prolonged weaning from mechanical ventilation: results from specialized weaning centers

2020 ◽  
Author(s):  
Wolfram Windisch ◽  
Dominic Dellweg ◽  
Jens Geiseler ◽  
Michael Westhoff ◽  
Michael Pfeifer ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Weaning From Mechanical Ventilation ◽  
Prolonged Weaning

Predictors of survival after prolonged weaning from mechanical ventilation

2020 ◽  
Vol 60 ◽  
pp. 212-217 ◽  
Author(s):  
Christian Warnke ◽  
Alexander Heine ◽  
Annegret Müller-Heinrich ◽  
Christine Knaak ◽  
Sigrun Friesecke ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Weaning From Mechanical Ventilation ◽  
Prolonged Weaning

Changes in Functional Residual Capacity During Weaning from Mechanical Ventilation: A Pilot Study

2009 ◽  
Vol 108 (3) ◽  
pp. 911-915 ◽  
Author(s):  
Hermann Heinze ◽  
Beate Sedemund-Adib ◽  
Matthias Heringlake ◽  
Torsten Meier ◽  
Wolfgang Eichler
Keyword(s):  
Mechanical Ventilation ◽  
Pilot Study ◽  
Functional Residual Capacity ◽  
Weaning From Mechanical Ventilation ◽  
Residual Capacity
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