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

Abstract

In critically ill septic patients, critical illness polyneuropathy significantly increases the duration of mechanical ventilation and prolongs the lengths of intensive care unit and hospital stays.

Noninvasive Monitoring of Cardiac Output During Weaning From Mechanical Ventilation: A Pilot Study

“…5,17,18 Most weaning protocols do not address the reason for an unsuccessful SBT. A patient's trial may be unsuccessful because of previously unknown premorbid conditions or other factors that ensued during the acute illness, 19 some of which may not be readily detectable by bedside assessment. A noninvasive cardiac output monitor provides a feasible method for assessing cardiac function during weaning.…”

The incidence of intensive care unit-acquired weakness syndromes: A systematic review

“…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.…”

“…These syndromes are now all included under the clinical diagnostic label of intensive care unit-acquired weakness (ICUAW). 10 The development of an ICUAW syndrome may have important consequences on patient outcomes; prolonged ventilatory weaning, 11,12 increased ICU 12 and hospital length of stay, 13 increased hospital mortality, 14,15 increased 180-day mortality 16 and persistent disabling weakness with reduced quality of life out to one year from ICU discharge. [17][18][19] There may also be a number of potentially modifiable risk factors for ICUAW; prolonged ICU stay/bed rest, 20,21 hyperglycaemia/insulin therapy, 13,[22][23][24] corticosteroids 20 and neuromuscular blockers.…”

Mechanisms of Neuromuscular Dysfunction in Critical Illness

“…The presence of NMD is also associated with clinically significant short and long-term morbidity. Both CIM and CIP are associated with prolonged duration of mechanical ventilation and increased length of hospital and ICU stay [13,15,35]. Thus the presence of acquired paresis can inform the clinical decision to pursue early tracheostomy and arrange for long-term care after hospital discharge.…”