This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (6) Citing Articles via Google Scholar Google Scholar Articles by Schweickert, W. D. Articles by Hall, J. Search for Related Content PubMed PubMed Citation Articles by Schweickert, W. D. Articles by Hall, J. Related Content Recent Advances in Chest Medicine Related Editorial

ICU-Acquired Weakness^*

^* From Pulmonary/Critical Care, Department of Medicine, University of Chicago, Chicago, IL.

Correspondence to: Jesse B. Hall, MD, FCCP, 5841 S Maryland Ave, MC 6026, Chicago, IL 60657; e-mail: jhall{at}medicine.bsd.uchicago.edu

Abstract

Observational studies of patients receiving prolonged mechanical ventilation and other forms of critical care support have determined acquired neuromuscular disorders to be extremely common. Early studies used electrophysiologic investigations to diagnose critical illness polyneuropathy (CIP) and muscle biopsy to confirm critical illness myopathy (CIM). More recent approaches seek to obviate these invasive techniques and build on a standardized bedside neuromuscular examination to identify patients with acquired weakness syndromes. Serial examination in the alert patient may serve as a reasonable prognosticator for most patients. The importance of ICU-acquired weakness syndromes is supported by the observation that muscle wasting and weakness are among the most prominent long-term complications of survivors of ARDS. In addition, a strong association appears to exist between acquired weakness and protracted ventilator dependence, an important determinant of ICU length of stay. Multivariate analysis has identified several risk factors associated with increased incidence for ICU-acquired weakness, including severe systemic inflammation, medications (specifically, corticosteroids and neuromuscular blocking agents), glycemic control, and immobility. We advocate an approach to this common syndrome that identifies risk factors early in the hope of minimizing their impact.

Key Words: critical illness • ICU-acquired weakness • myopathy • polyneuromyopathy

Related Editorial

Managing the Nervous System Effects of Sepsis

Charles F. Bolton and G. Bryan Young
Chest 2007 131: 1273-1274. [Full Text] [PDF]

This article has been cited by other articles:

				C. F. Bolton and G. B. Young Managing the Nervous System Effects of Sepsis Chest, May 1, 2007; 131(5): 1273 - 1274. [Full Text] [PDF]