Critical illness polyneuropathy: a new iatrogenically induced syndrome after cardiac surgery?

Thiele, Rudolf; Jakob, Heinz; Hund, Ernst; Genzwuerker, H. V.; Herold, Ulf; Schweiger, P.; Hagl, S.

doi:10.1016/s1010-7940(97)00273-x

Cited by 34 publications

(21 citation statements)

References 17 publications

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“…In contrast, in a group of cardiac surgical patients the use of renal replacement therapy was more frequent in those diagnosed with CIP, although the incidence of sepsis and the severity of the process were significantly higher than in the control group [28]. Since the number of patients with renal failure and the severity of this process were similar in the two groups, the likely explanation of our finding is that the use of renal replacement therapy allows for the control of metabolic disturbances or is a means of eliminating a low-molecular toxic agent that might be implicated in CIP development [29].…”

Section: Discussionmentioning

confidence: 69%

Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients

et al. 2001

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Section: Discussionmentioning

confidence: 69%

Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients

et al. 2001

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“…The contribution of CINMA to prolonged mechanical ventilation has been studied in 10 cohorts of ICU patients [54,56,[65][66][67][68][69][70][71][72]. Four studies have shown an association between CINMA and an increased duration of weaning or weaning failure [49,67,70,71].…”

Section: Peripheral Dysfunctionmentioning

confidence: 99%

Weaning from mechanical ventilation

Boles

Bion

Connors³

et al. 2007

Eur Respir J

1,660

1,499

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Weaning covers the entire process of liberating the patient from mechanical support and from the endotracheal tube. Many controversial questions remain concerning the best methods for conducting this process. An International Consensus Conference was held in April 2005 to provide recommendations regarding the management of this process. An 11-member international jury answered five pre-defined questions. 1) What is known about the epidemiology of weaning problems? 2) What is the pathophysiology of weaning failure? 3) What is the usual process of initial weaning from the ventilator? 4) Is there a role for different ventilator modes in more difficult weaning? 5) How should patients with prolonged weaning failure be managed?The main recommendations were as follows. 1) Patients should be categorised into three groups based on the difficulty and duration of the weaning process. 2) Weaning should be considered as early as possible. 3) A spontaneous breathing trial is the major diagnostic test to determine whether patients can be successfully extubated. 4) The initial trial should last 30 min and consist of either T-tube breathing or low levels of pressure support. 5) Pressure support or assist–control ventilation modes should be favoured in patients failing an initial trial/trials. 6) Noninvasive ventilation techniques should be considered in selected patients to shorten the duration of intubation but should not be routinely used as a tool for extubation failure.

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“…44 Aminoglycoside antibiotics were associated with paresis in a single study; however, additional observational studies demonstrated no significant association. 6,34,36,39,40 There are single studies suggesting that other potentially modifiable ICU interventions, including liberal fluid administration and transfusion, journal.publications.chestnet.org may contribute to ICUAW, although these associations need verification in larger patient cohorts. 45,46 Prolonged immobilization is associated with atrophy in patients who are critically ill.…”

Section: In-hospital Risk Factors For Icuawmentioning

confidence: 99%

ICU-Acquired Weakness

Jolley

Bunnell

Hough

2016

Chest

279

229

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Survivorship after critical illness is an increasingly important health-care concern as ICU use continues to increase while ICU mortality is decreasing. Survivors of critical illness experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay. Newfound impairment is associated with increased health-care costs and use, reductions in health-related quality of life, and prolonged unemployment. Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in patients who are critically ill, with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysfunction. ICU-acquired weakness (ICUAW) is associated with longer durations of mechanical ventilation and hospitalization, along with greater functional impairment for survivors. Although there is increasing recognition of ICUAW as a clinical entity, significant knowledge gaps exist concerning identifying patients at high risk for its development and understanding its role in long-term outcomes after critical illness. This review addresses the epidemiologic and pathophysiologic aspects of ICUAW; highlights the diagnostic challenges associated with its diagnosis in patients who are critically ill; and proposes, to our knowledge, a novel strategy for identifying ICUAW.

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Critical illness polyneuropathy: a new iatrogenically induced syndrome after cardiac surgery?

Cited by 34 publications

References 17 publications

Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients

Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients

Weaning from mechanical ventilation

ICU-Acquired Weakness

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